Comorbidity in adults with traumatic brain injury and all-cause mortality: a systematic review
Objectives Comorbidity in traumatic brain injury (TBI) has been recognised to alter the clinical course of patients and influence short-term and long-term outcomes. We synthesised the evidence on the effects of different comorbid conditions on early and late mortality post-TBI in order to (1) examin...
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BMJ Publishing Group
2019-11-01
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| Series: | BMJ Open |
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| author | Angela Colantonio Tatyana Mollayeva Michael Escobar Chen Xiong Sara Hanafy Vincy Chan Zheng Jing Hu Mitchell Sutton |
| author_facet | Angela Colantonio Tatyana Mollayeva Michael Escobar Chen Xiong Sara Hanafy Vincy Chan Zheng Jing Hu Mitchell Sutton |
| author_sort | Angela Colantonio |
| collection | DOAJ |
| description | Objectives Comorbidity in traumatic brain injury (TBI) has been recognised to alter the clinical course of patients and influence short-term and long-term outcomes. We synthesised the evidence on the effects of different comorbid conditions on early and late mortality post-TBI in order to (1) examine the relationship between comorbid condition(s) and all-cause mortality in TBI and (2) determine the influence of sociodemographic and clinical characteristics of patients with a TBI at baseline on all-cause mortality.Design Systematic review.Data sources Medline, Central, Embase, PsycINFO and bibliographies of identified articles were searched from May 1997 to January 2019.Eligibility criteria for selecting studies Included studies met the following criteria: (1) focused on comorbidity as it related to our outcome of interest in adults (ie, ≥18 years of age) diagnosed with a TBI; (2) comorbidity was detected by any means excluding self-report; (3) reported the proportion of participants without comorbidity and (4) followed participants for any period of time.Data extraction and synthesis Two independent reviewers extracted the data and assessed risk of bias using the Quality in Prognosis Studies tool. Data were synthesised through tabulation and qualitative description.Results A total of 27 cohort studies were included. Among the wide range of individual comorbid conditions studied, only low blood pressure was a consistent predictors of post-TBI mortality. Other consistent predictors were traditional sociodemographic risk factors. Higher comorbidity scale, scores and the number of comorbid conditions were not consistently associated with post-TBI mortality.Conclusions Given the high number of comorbid conditions that were examined by the single studies, research is required to further substantiate the evidence and address conflicting findings. Finally, an enhanced set of comorbidity measures that are suited for the TBI population will allow for better risk stratification to guide TBI management and treatment.PROSPERO registration number CRD42017070033 |
| format | Article |
| id | doaj-art-4e021a33343f42248e03260c4fc18a94 |
| institution | OA Journals |
| issn | 2044-6055 |
| language | English |
| publishDate | 2019-11-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-4e021a33343f42248e03260c4fc18a942025-08-20T02:06:51ZengBMJ Publishing GroupBMJ Open2044-60552019-11-0191110.1136/bmjopen-2019-029072Comorbidity in adults with traumatic brain injury and all-cause mortality: a systematic reviewAngela Colantonio0Tatyana Mollayeva1Michael Escobar2Chen Xiong3Sara Hanafy4Vincy Chan5Zheng Jing Hu6Mitchell Sutton7Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, CanadaRehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada4 Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada2 KITE-Toronto Rehab-University Health Network, Toronto, Ontario, Canada1 Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada3 KITE -Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, CanadaDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada2 Centre for Prognosis Studies in the Rheumatic Diseases, Schroeder Arthritis Institute, University Health Network, Toronto, Ontario, CanadaObjectives Comorbidity in traumatic brain injury (TBI) has been recognised to alter the clinical course of patients and influence short-term and long-term outcomes. We synthesised the evidence on the effects of different comorbid conditions on early and late mortality post-TBI in order to (1) examine the relationship between comorbid condition(s) and all-cause mortality in TBI and (2) determine the influence of sociodemographic and clinical characteristics of patients with a TBI at baseline on all-cause mortality.Design Systematic review.Data sources Medline, Central, Embase, PsycINFO and bibliographies of identified articles were searched from May 1997 to January 2019.Eligibility criteria for selecting studies Included studies met the following criteria: (1) focused on comorbidity as it related to our outcome of interest in adults (ie, ≥18 years of age) diagnosed with a TBI; (2) comorbidity was detected by any means excluding self-report; (3) reported the proportion of participants without comorbidity and (4) followed participants for any period of time.Data extraction and synthesis Two independent reviewers extracted the data and assessed risk of bias using the Quality in Prognosis Studies tool. Data were synthesised through tabulation and qualitative description.Results A total of 27 cohort studies were included. Among the wide range of individual comorbid conditions studied, only low blood pressure was a consistent predictors of post-TBI mortality. Other consistent predictors were traditional sociodemographic risk factors. Higher comorbidity scale, scores and the number of comorbid conditions were not consistently associated with post-TBI mortality.Conclusions Given the high number of comorbid conditions that were examined by the single studies, research is required to further substantiate the evidence and address conflicting findings. Finally, an enhanced set of comorbidity measures that are suited for the TBI population will allow for better risk stratification to guide TBI management and treatment.PROSPERO registration number CRD42017070033https://bmjopen.bmj.com/content/9/11/e029072.full |
| spellingShingle | Angela Colantonio Tatyana Mollayeva Michael Escobar Chen Xiong Sara Hanafy Vincy Chan Zheng Jing Hu Mitchell Sutton Comorbidity in adults with traumatic brain injury and all-cause mortality: a systematic review BMJ Open |
| title | Comorbidity in adults with traumatic brain injury and all-cause mortality: a systematic review |
| title_full | Comorbidity in adults with traumatic brain injury and all-cause mortality: a systematic review |
| title_fullStr | Comorbidity in adults with traumatic brain injury and all-cause mortality: a systematic review |
| title_full_unstemmed | Comorbidity in adults with traumatic brain injury and all-cause mortality: a systematic review |
| title_short | Comorbidity in adults with traumatic brain injury and all-cause mortality: a systematic review |
| title_sort | comorbidity in adults with traumatic brain injury and all cause mortality a systematic review |
| url | https://bmjopen.bmj.com/content/9/11/e029072.full |
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