Mortality and morbidity from moderate to severe traumatic brain injury in Argentina

Carlos Rondina, Walter Videtta, Gustavo Petroni, Silvia Lujan, Pablo Schoon, Lilian Benito Mori, Javier Matkovich, Nancy Carney, Randall Chesnut

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

After adopting the Guidelines for the Management of Severe Head Injury, critical care physicians in Argentina reduced the mortality rate of patients with traumatic brain injury (TBI). However, there is no in-hospital or postdischarge rehabilitation services for persons with TBI in Argentina. Thus, severely disabled survivors were being discharged to home without follow-up or long-term care. Objectives: The objectives of this project were to establish a structure for conducting research about TBI in Argentina, and to conduct a prospective, observational study of outcomes from TBI in hospitals that had adopted the acute care guidelines. The goal was to document outcomes for people treated in a medical system that does not provide TBI rehabilitation. The focus of this report is mortality and morbidity during the acute care and hospital ward treatment of TBI in Argentina. Methods: We established a data-collection system in 5 hospitals in Argentina, using instruments and protocols developed by the NIDRR-funded TBI Model System program. Data-collection intervals were established to be comparable with intervals used in the TBI Model System program. The Argentine team consists of 11 neurocritical care physicians and 1 project manager/translator. All patient evaluation, data collection and entry, quality control, and local administration were conducted by this group. Results: Over 31 months, 278 patients were entered into the study. Approximately 61% were discharged from acute care directly to home. The in-hospital mortality rate was 31%. Seventy-six percent of expired patients died from secondary complications such as sepsis and pneumonia, and 93% while in the hospital. Discussion: TBI is a major public health concern in Argentina. However, rehabilitation for TBI is not a part of this country's medical system. The greatest proportion of expired patients in the Argentine sample died of secondary complications such as pneumonia or sepsis, which may have been avoided employing basic medical rehabilitation. The next research questions to be addressed in this population should be designed to identify solutions to the immediate need for rehabilitation, including treatment efficacy questions as well as questions about systems for delivering treatments.

Original languageEnglish (US)
Pages (from-to)368-376
Number of pages9
JournalJournal of Head Trauma Rehabilitation
Volume20
Issue number4
StatePublished - Jul 2005

Fingerprint

Argentina
Morbidity
Mortality
Rehabilitation
Sepsis
Pneumonia
Traumatic Brain Injury
Guidelines
Physicians
Long-Term Care
Critical Care
Hospital Mortality
Craniocerebral Trauma
Research
Information Systems
Quality Control
Observational Studies
Survivors
Public Health
Prospective Studies

Keywords

  • Argentina
  • Outcomes
  • Rehabilitation
  • Traumatic brain injury

ASJC Scopus subject areas

  • Rehabilitation
  • Clinical Neurology
  • Health Professions(all)

Cite this

Rondina, C., Videtta, W., Petroni, G., Lujan, S., Schoon, P., Mori, L. B., ... Chesnut, R. (2005). Mortality and morbidity from moderate to severe traumatic brain injury in Argentina. Journal of Head Trauma Rehabilitation, 20(4), 368-376.

Mortality and morbidity from moderate to severe traumatic brain injury in Argentina. / Rondina, Carlos; Videtta, Walter; Petroni, Gustavo; Lujan, Silvia; Schoon, Pablo; Mori, Lilian Benito; Matkovich, Javier; Carney, Nancy; Chesnut, Randall.

In: Journal of Head Trauma Rehabilitation, Vol. 20, No. 4, 07.2005, p. 368-376.

Research output: Contribution to journalArticle

Rondina, C, Videtta, W, Petroni, G, Lujan, S, Schoon, P, Mori, LB, Matkovich, J, Carney, N & Chesnut, R 2005, 'Mortality and morbidity from moderate to severe traumatic brain injury in Argentina', Journal of Head Trauma Rehabilitation, vol. 20, no. 4, pp. 368-376.
Rondina C, Videtta W, Petroni G, Lujan S, Schoon P, Mori LB et al. Mortality and morbidity from moderate to severe traumatic brain injury in Argentina. Journal of Head Trauma Rehabilitation. 2005 Jul;20(4):368-376.
Rondina, Carlos ; Videtta, Walter ; Petroni, Gustavo ; Lujan, Silvia ; Schoon, Pablo ; Mori, Lilian Benito ; Matkovich, Javier ; Carney, Nancy ; Chesnut, Randall. / Mortality and morbidity from moderate to severe traumatic brain injury in Argentina. In: Journal of Head Trauma Rehabilitation. 2005 ; Vol. 20, No. 4. pp. 368-376.
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abstract = "After adopting the Guidelines for the Management of Severe Head Injury, critical care physicians in Argentina reduced the mortality rate of patients with traumatic brain injury (TBI). However, there is no in-hospital or postdischarge rehabilitation services for persons with TBI in Argentina. Thus, severely disabled survivors were being discharged to home without follow-up or long-term care. Objectives: The objectives of this project were to establish a structure for conducting research about TBI in Argentina, and to conduct a prospective, observational study of outcomes from TBI in hospitals that had adopted the acute care guidelines. The goal was to document outcomes for people treated in a medical system that does not provide TBI rehabilitation. The focus of this report is mortality and morbidity during the acute care and hospital ward treatment of TBI in Argentina. Methods: We established a data-collection system in 5 hospitals in Argentina, using instruments and protocols developed by the NIDRR-funded TBI Model System program. Data-collection intervals were established to be comparable with intervals used in the TBI Model System program. The Argentine team consists of 11 neurocritical care physicians and 1 project manager/translator. All patient evaluation, data collection and entry, quality control, and local administration were conducted by this group. Results: Over 31 months, 278 patients were entered into the study. Approximately 61{\%} were discharged from acute care directly to home. The in-hospital mortality rate was 31{\%}. Seventy-six percent of expired patients died from secondary complications such as sepsis and pneumonia, and 93{\%} while in the hospital. Discussion: TBI is a major public health concern in Argentina. However, rehabilitation for TBI is not a part of this country's medical system. The greatest proportion of expired patients in the Argentine sample died of secondary complications such as pneumonia or sepsis, which may have been avoided employing basic medical rehabilitation. The next research questions to be addressed in this population should be designed to identify solutions to the immediate need for rehabilitation, including treatment efficacy questions as well as questions about systems for delivering treatments.",
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