Effects of Concomitant Traumatic Spinal Cord and Brain Injury on In-Hospital Mortality: A Retrospective Analysis of a Nationwide Trauma Registry in Japan

Tachino, Jotaro; Demetriades, Andreas K.; Peul, Wilco; Nakao, Shunichiro; Katayama, Yusuke; Tanaka, Kenta; Kitamura, Tetsuhisa; Hirose, Tomoya; Kiyohara, Kosuke; Umemura, Yutaka; Kiguchi, Takeyuki; Ojima, Masahiro; Ishida, Kenichiro; Oda, Jun

doi:https://doi.org/10.1089/neu.2024.0168

Effects of Concomitant Traumatic Spinal Cord and Brain Injury on In-Hospital Mortality: A Retrospective Analysis of a Nationwide Trauma Registry in Japan

Tachino, Jotaro; Demetriades, Andreas K.; Peul, Wilco et al.

Journal of Neurotrauma, 2024, 41, 17-18

Number of Access:1,647（2025-08-16 03:18 Counts）

Identifier to cite or link to this item: https://hdl.handle.net/11094/98149

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Title	Effects of Concomitant Traumatic Spinal Cord and Brain Injury on In-Hospital Mortality: A Retrospective Analysis of a Nationwide Trauma Registry in Japan
Creator	NRID 1000050747152 1000050747152 ORCID 0000-0002-0423-7713 0000-0002-0423-7713 researchmap permalink jotarotachino jotarotachino Scopus Author ID 57203882578 57203882578 CreatorName Tachino, Jotaro
	CreatorName Demetriades, Andreas K.
	CreatorName Peul, Wilco
	NRID 1000080834150 1000080834150 ORCID 0000-0001-5530-806X 0000-0001-5530-806X researchmap permalink shunichironakao shunichironakao Scopus Author ID 57216959268 57216959268 CreatorName Nakao, Shunichiro
	NRID 1000050747144 1000050747144 ORCID 0000-0003-2585-4259 0000-0003-2585-4259 researchmap permalink orion2013 orion2013 Scopus Author ID 56470235000 56470235000 CreatorName Katayama, Yusuke
	CreatorName Tanaka, Kenta
	NRID 1000030639810 1000030639810 ORCID 0000-0003-0107-0580 0000-0003-0107-0580 researchmap permalink Kitamura_T Kitamura_T Scopus Author ID 22234282700 22234282700 CreatorName Kitamura, Tetsuhisa
	NRID 1000070597509 1000070597509 researchmap permalink tomoyahirose tomoyahirose Scopus Author ID 41861413300 41861413300 CreatorName Hirose, Tomoya
	NRID 1000080581834 1000080581834 CreatorName Kiyohara, Kosuke
	NRID 1000020743561 1000020743561 CreatorName Umemura, Yutaka
	NRID 1000030724380 1000030724380 CreatorName Kiguchi, Takeyuki
	NRID 1000070721091 1000070721091 ORCID 0000-0001-7490-1539 0000-0001-7490-1539 researchmap permalink ojimamasahiro ojimamasahiro CreatorName Ojima, Masahiro
	CreatorName Ishida, Kenichiro
	NRID 1000060459500 1000060459500 ORCID 0000-0002-8254-3716 0000-0002-8254-3716 researchmap permalink read0068529 read0068529 Scopus Author ID 56210537000 56210537000 CreatorName Oda, Jun
Subject	concomitant trauma
	interaction effect
	nationwide cohort study
	traumatic brain injury
	traumatic spinal cord injury
Description	Tachino J., Demetriades A.K., Peul W., et al. Effects of Concomitant Traumatic Spinal Cord and Brain Injury on In-Hospital Mortality: A Retrospective Analysis of a Nationwide Trauma Registry in Japan. Journal of Neurotrauma 41, 17 (2024); https://doi.org/10.1089/neu.2024.0168.
Abstract	Isolated traumatic spinal cord injury (t-SCI) and traumatic brain injury (TBI) represent significant public health concerns, resulting in long-term disabilities and necessitating sophisticated care, particularly when occurring concurrently. The impact of these combined injuries, while crucial in trauma management, on clinical, socioeconomic, and health care outcomes is largely unknown. To address this gap, our secondary retrospective cohort study used data from the Japan Trauma Data Bank, covering patients enrolled over a 13-year period (2006-2018), to elucidate the effects of concurrent t-SCI and TBI on in-hospital mortality. Data on patient demographics, injury characteristics, treatment modalities, and outcomes were analyzed. Multivariate logistic regression analysis was performed to examine prognostic variables associated with in-hospital mortality, including interaction terms between t-SCI severity and TBI presence. This study included 91,983 patients with neurotrauma, with a median age of 62 years (69.7% men). Among the patients, 9,018 (9.8%) died in the hospital. Concomitant t-SCI and TBI occurred in 2,954 (3.2%) patients. t-SCI only occurred in 9,590 (10.4%) patients, whereas TBI only occurred in the majority of these cases (79,439, 86.4%). Multivariate logistic regression analysis revealed age; sex; total number of comorbidities; systolic blood pressure at presentation; Glasgow coma scale score at presentation; and Abbreviated Injury Scale (AIS) scores for head, face, chest, abdomen, cervical-SCI, thoracic-SCI, and lumbar-SCI as significant independent factors for in-hospital mortality. The odds ratio of cervical-SCI × head AIS as an interaction term was 0.85 (95% confidence interval: 0.77-0.95), indicating a negative interaction. In conclusion, we identified 12 factors associated with in-hospital mortality in patients with t-SCI. In addition, the negative interaction between cervical t-SCI and TBI suggests that the presence of t-SCI in patients with TBI may be underestimated. This study highlights the importance of early recognition and comprehensive management of these complex trauma conditions while considering the possibility of concomitant t-SCI in patients with TBI.
Publisher	Mary Ann Liebert Inc.
Source Title	Journal of Neurotrauma
Volume (Issue)	41
Page	17-18
Date of Issued	2024-09-17
Language	English
Handle URL	https://hdl.handle.net/11094/98149
PISSN	08977151
eISSN	15579042
Relation.isIdenticalTo	DOI (Publisher Version) https://doi.org/10.1089/neu.2024.0168
Access Rights	open access
CopyRight	This article is licensed under a Creative Commons Attribution 4.0 International License.
oaire:version	Version of Record
Category	学術雑誌論文 Journal Article

Resource Type	journal article
Local Type	Journal Article
DCTERMS.bibliographicCitation	Journal of Neurotrauma. 2024, 41, p. 17-18
DC.title	Effects of Concomitant Traumatic Spinal Cord and Brain Injury on In-Hospital Mortality: A Retrospective Analysis of a Nationwide Trauma Registry in Japan
DC.creator	Tachino, Jotaro
	Demetriades, Andreas K.
	Peul, Wilco
	Nakao, Shunichiro
	Katayama, Yusuke
	Tanaka, Kenta
	Kitamura, Tetsuhisa
	Hirose, Tomoya
	Kiyohara, Kosuke
	Umemura, Yutaka
	Kiguchi, Takeyuki
	Ojima, Masahiro
	Ishida, Kenichiro
	Oda, Jun
DC.publisher	Mary Ann Liebert Inc.
DC.language' scheme='DCTERMS.RFC1766	English
DCTERMS.issued' scheme='DCTERMS.W3CDTF	2024-09-17
DC.identifier	https://doi.org/10.1089/neu.2024.0168
DC.subject	concomitant trauma
	interaction effect
	nationwide cohort study
	traumatic brain injury
	traumatic spinal cord injury
DC.description	Tachino J., Demetriades A.K., Peul W., et al. Effects of Concomitant Traumatic Spinal Cord and Brain Injury on In-Hospital Mortality: A Retrospective Analysis of a Nationwide Trauma Registry in Japan. Journal of Neurotrauma 41, 17 (2024); https://doi.org/10.1089/neu.2024.0168.
DCTERMS.abstract	Isolated traumatic spinal cord injury (t-SCI) and traumatic brain injury (TBI) represent significant public health concerns, resulting in long-term disabilities and necessitating sophisticated care, particularly when occurring concurrently. The impact of these combined injuries, while crucial in trauma management, on clinical, socioeconomic, and health care outcomes is largely unknown. To address this gap, our secondary retrospective cohort study used data from the Japan Trauma Data Bank, covering patients enrolled over a 13-year period (2006-2018), to elucidate the effects of concurrent t-SCI and TBI on in-hospital mortality. Data on patient demographics, injury characteristics, treatment modalities, and outcomes were analyzed. Multivariate logistic regression analysis was performed to examine prognostic variables associated with in-hospital mortality, including interaction terms between t-SCI severity and TBI presence. This study included 91,983 patients with neurotrauma, with a median age of 62 years (69.7% men). Among the patients, 9,018 (9.8%) died in the hospital. Concomitant t-SCI and TBI occurred in 2,954 (3.2%) patients. t-SCI only occurred in 9,590 (10.4%) patients, whereas TBI only occurred in the majority of these cases (79,439, 86.4%). Multivariate logistic regression analysis revealed age; sex; total number of comorbidities; systolic blood pressure at presentation; Glasgow coma scale score at presentation; and Abbreviated Injury Scale (AIS) scores for head, face, chest, abdomen, cervical-SCI, thoracic-SCI, and lumbar-SCI as significant independent factors for in-hospital mortality. The odds ratio of cervical-SCI × head AIS as an interaction term was 0.85 (95% confidence interval: 0.77-0.95), indicating a negative interaction. In conclusion, we identified 12 factors associated with in-hospital mortality in patients with t-SCI. In addition, the negative interaction between cervical t-SCI and TBI suggests that the presence of t-SCI in patients with TBI may be underestimated. This study highlights the importance of early recognition and comprehensive management of these complex trauma conditions while considering the possibility of concomitant t-SCI in patients with TBI.
DC.rights	This article is licensed under a Creative Commons Attribution 4.0 International License.
DC.format	98149
citation_title	Effects of Concomitant Traumatic Spinal Cord and Brain Injury on In-Hospital Mortality: A Retrospective Analysis of a Nationwide Trauma Registry in Japan
citation_author	Tachino, Jotaro
	Demetriades, Andreas K.
	Peul, Wilco
	Nakao, Shunichiro
	Katayama, Yusuke
	Tanaka, Kenta
	Kitamura, Tetsuhisa
	Hirose, Tomoya
	Kiyohara, Kosuke
	Umemura, Yutaka
	Kiguchi, Takeyuki
	Ojima, Masahiro
	Ishida, Kenichiro
	Oda, Jun
citation_publisher	Mary Ann Liebert Inc.
citation_language	English
citation_date	2024-09-17
citation_journal_title	Journal of Neurotrauma
citation_volume	41
citation_firstpage	17
citation_lastpage	18
citation_doi	https://doi.org/10.1089/neu.2024.0168
citation_public_url	https://hdl.handle.net/11094/98149

Effects of Concomitant Traumatic Spinal Cord and Brain Injury on In-Hospital Mortality: A Retrospective Analysis of a Nationwide Trauma Registry in Japan

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