Abstract
ObjectivesOsteoporosis Self-Assessment Tool for Asians (OSTA) has been proved to be a simple and effective tool for recognizing osteoporosis risk. Our previous study has demonstrated that the preoperative OSTA index was a good prognostic predictor for stage II and III colon cancer patients after surgery. We aim to evaluate the value of OSTA index in prognostication of isolated traumatic brain injury with moderate severity (GCS 9-13).MethodsWe retrospectively reviewed all patients visiting Kaohsiung Medical University Hospital emergency department due to isolated moderate traumatic brain injury from Jan. 2010 to Dec. 2012. Background data (including the OSTA index), clinical presentations, management and outcomes (ICU admission days, total admission days, complications, Glasgow outcome score (GOS) at discharge, mortality) of the patients were recorded for further analysis. Our major outcome was good neurologic recovery defined as GOS of 5. Pearson chi-square test and the Mann-Whitney U test were used to compare demographic features. Multiple logistic regression was used to identify independent risk factors.Results107 isolated moderate TBI patients were studied. 40 patients (37.4%) showed good recovery and 10 (9.3%) died at discharge. The univariate analysis revealed that younger age, higher OSTA index, lower ISS, lower AIS-H, and avoidance to neurosurgery were associated with better neurologic outcome for all moderate TBI patients. Multivariate analysis revealed that lower ISS, higher OSTA, and the avoidance of neurosurgery were independent risk factors predicting good neurologic recovery.ConclusionHigher ISS, lower OSTA index and exposure to neurosurgery were the independent risk factors for poorer recovery from isolated moderate TBI. In addition to labeling the cohort harboring osteoporotic risk, OSTA index could predict neurologic prognosis in patients with isolated moderate traumatic brain injury.
Highlights
Traumatic brain injury (TBI) is a disease harboring significantly injurious impact on society and individuals
The univariate analysis revealed that younger age, higher Osteoporosis Screening Tool for Asians (OSTA) index, lower Injury Severity Score (ISS), lower AIS-H, and avoidance to neurosurgery were associated with better neurologic outcome for all moderate TBI patients
Multivariate analysis revealed that lower ISS, higher OSTA, and the avoidance of neurosurgery were independent risk factors predicting good neurologic recovery
Summary
Traumatic brain injury (TBI) is a disease harboring significantly injurious impact on society and individuals. Novel prognostic factors of TBI have been studied in animal experiments or clinical trials, such as estrogen, progesterone, vitamin D, etc [4,5,6,7,8,9,10]. Many of these factors were the contributing factors of osteoporosis [10,11,12,13,14]. The relationship between osteoporosis risk and TBI outcomes has been rarely investigated
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