1. Predictors of in-hospital mortality following hypoxic-ischemic brain injury: a population-based study.
- Author
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Jacob, Binu, Stock, David, Chan, Vincy, Colantonio, Angela, and Cullen, Nora
- Subjects
BRAIN injuries ,CONFIDENCE intervals ,CRITICAL care medicine ,LENGTH of stay in hospitals ,HOSPITAL admission & discharge ,HOSPITAL emergency services ,LONGITUDINAL method ,OBSTRUCTIVE lung diseases ,MENTAL illness ,MULTIVARIATE analysis ,PATIENTS ,REGRESSION analysis ,RISK assessment ,TRACHEOTOMY ,PROPORTIONAL hazards models ,RETROSPECTIVE studies ,CEREBRAL anoxia-ischemia ,HOSPITAL mortality ,ODDS ratio ,DISEASE complications - Abstract
Objective: To identify predictors of in-hospital mortality following Hypoxic-Ischemic Brain Injury (HIBI) using the Anderson Behavioral Model. Design and Setting: Population based retrospective cohort study in Ontario, Canada with data collected between 1 April 2002 and 31 March 2017. Patients: Adult patients aged 20 years and older with HIBI-related acute care admission were identified in the health administrative data. Multivariable cox proportional hazard regression models were used to identify predisposing, need and enabling factors that predict in-hospital mortality. Results: Of the 7492 patients admitted to acute care with HIBI, the in-hospital mortality rate was 71%. The predisposing factors associated with mortality were female sex (HR, 1.16; 95% CI, 1.10–1.23) and older age (65–79 vs. 20–34: HR, 1.17; 95% CI, 1.02–1.35). The need factors associated with mortality were the presence of COPD (HR, 1.10; 95% CI, 1.02–1.17), psychiatric illness (HR, 1.13; 95% CI, 1.05–1.20) injury due to cardiac illness (HR, 1.19; 95% CI, 1.12–1.26) and longer emergency department length of stay. Having spending any time in an alternate level of care and the application of tracheotomy procedures were found to reduce mortality.Conclusions: The acute/critical care centers need to consider these findings to adopt prevention strategies targeting reduced in-hospital mortality. [ABSTRACT FROM AUTHOR]
- Published
- 2020
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