Association between the Osteoporosis Self-Assessment Tool for Asians Score and Mortality in Patients with Isolated Moderate and Severe Traumatic Brain Injury: A Propensity Score-Matched Analysis

Cheng-Shyuan Rau, Pao-Jen Kuo, Shao-Chun Wu, Yi-Chun Chen, Hsiao-Yun Hsieh and Ching-Hua Hsieh
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Cheng-Shyuan Rau: Department of Neurosurgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan
Pao-Jen Kuo: Chang Gung University College of Medicine, Taoyuan City 33302, Taiwan
Shao-Chun Wu: Chang Gung University College of Medicine, Taoyuan City 33302, Taiwan
Yi-Chun Chen: Chang Gung University College of Medicine, Taoyuan City 33302, Taiwan
Hsiao-Yun Hsieh: Chang Gung University College of Medicine, Taoyuan City 33302, Taiwan
Ching-Hua Hsieh: Chang Gung University College of Medicine, Taoyuan City 33302, Taiwan

IJERPH, 2016, vol. 13, issue 12, 1-14

Abstract: Background: The purpose of this study was to use a propensity score-matched analysis to investigate the association between the Osteoporosis Self-Assessment Tool for Asians (OSTA) scores and clinical outcomes of patients with isolated moderate and severe traumatic brain injury (TBI). Methods: The study population comprised 7855 patients aged ≥40 years who were hospitalized for treatment of isolated moderate and severe TBI (an Abbreviated Injury Scale (AIS) ≥3 points only in the head and not in other regions of the body) between 1 January 2009 and 31 December 2014. Patients were categorized as high-risk (OSTA score < −4; n = 849), medium-risk (−4 ≤ OSTA score ≤ −1; n = 1647), or low-risk (OSTA score > −1; n = 5359). Two-sided Pearson’s chi-squared, or Fisher’s exact tests were used to compare categorical data. Unpaired Student’s t -test and Mann-Whitney U test were performed to analyze normally and non-normally distributed continuous data, respectively. Propensity score-matching in a 1:1 ratio was performed using NCSS software, with adjustment for covariates. Results: Compared to low-risk patients, high- and medium-risk patients were significantly older and injured more severely. The high- and medium-risk patients had significantly higher mortality rates, longer hospital length of stay, and a higher proportion of admission to the intensive care unit than low-risk patients. Analysis of propensity score-matched patients with adjusted covariates, including gender, co-morbidity, blood alcohol concentration level, Glasgow Coma Scale score, and Injury Severity Score revealed that high- and medium-risk patients still had a 2.4-fold (odds ratio (OR), 2.4; 95% confidence interval (CI), 1.39–4.15; p = 0.001) and 1.8-fold (OR, 1.8; 95% CI, 1.19–2.86; p = 0.005) higher mortality, respectively, than low-risk patients. However, further addition of age as a covariate for the propensity score-matching demonstrated that there was no significant difference between high-risk and low-risk patients or between medium-risk and low-risk patients, implying that older age may contribute to the significantly higher mortality associated with a lower OSTA score. Conclusions: Older age may be able to explain the association of lower OSTA score and higher mortality rates in patients with isolated moderate and severe TBI.

Keywords: Osteoporosis Self-Assessment Tool for Asians (OSTA); mortality; traumatic brain injury (TBI); injury severity score (ISS); osteoporosis (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2016
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (2)

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