Greater Mortality Research Articles

Effects of Inorganic and Organic Pollutants on the Biomarkers' Response of Cerastoderma edule under Temperature Scenarios.

Currently, there is increased chemical pollution, and climate change is a major concern to scientific, political and social communities globally. Marine systems are very susceptible to changes, and considering the ecological and economic roles of bivalve species, like Cerastoderma edule, studies evaluating the effects of both stressors are of great importance. This study intends to (a) determine the toxicity of copper (Cu) and oxyfluorfen at the lethal level, considering the temperature; (b) assess the changes in the antioxidant defence enzymes as a consequence of the simultaneous exposure to chemical and warming pressures; and (c) determine if lipid peroxidation (LPO) and neurotoxic effects occur after the exposure to chemical and temperature stressors. C. edule was exposed to Cu and oxyfluorfen at different temperatures (15 °C, 20 °C and 25 °C) for 96 h. The ecotoxicological results reveal a higher tolerance of C. edule to oxyfluorfen than to Cu, regardless of the temperature. The antioxidant defence system revealed efficiency in fighting the chemicals' action, with no significant changes in the thiobarbituric reactive species (TBARS) levels to 15 °C and 20 °C. However, a significant inhibition of acetylcholinesterase (AChE) was observed on the organisms exposed to oxyfluorfen at 20 °C, as well as a decreasing trend on the ones exposed to Cu at this temperature. Moreover, the catalase (CAT) showed a significant increase in the organisms exposed to the two highest concentrations of Cu at 15 °C and in the ones exposed to the highest concentration of oxyfluorfen at 20 °C. Looking at the temperature as a single stressor, the organisms exposed to 25 °C revealed a significant increase in the TBARS level, suggesting potential LPO and explaining the great mortality at this condition.

New-onset postoperative atrial fibrillation after mitral valve surgery: Determinants and the effect on survival

ObjectiveMitral valve surgery (MVS) carries substantial risk of postoperative atrial fibrillation (PAF). Identifying patients who benefit from prophylactic left atrial appendage amputation (LAAA) or maze is ill-defined. To guide such interventions, we determined preoperative predictors of PAF and investigated 3-year survival of patients with PAF. MethodsWe performed a retrospective analysis of patients undergoing isolated MVS (N = 670) between 2011 and 2021. Patients with preoperative atrial fibrillation, LAAA or pulmonary vein isolation were excluded. Patient characteristics were compared between those without PAF and those who developed transient or prolonged PAF. Predictors of any PAF and prolonged PAF were identified using multivariable regression analysis. ResultsIn total, 504 patients without preoperative atrial fibrillation underwent isolated MVS. Of them, 303 patients (60.2%) developed PAF; 138 (27.3%) developed transient and 165 (32.7%) developed prolonged (beyond 30 days) PAF. Patients with PAF were older (65.7 vs 54.3 years, P < .001), with larger left atria (4.8 vs 4.3 cm, P < .001), greater prevalence of hypertension (60% vs 47.8%, P < .05), and were New York Heart Association class III/IV (36% vs 8.5%, P < .001). Independent predictors of PAF included left atria volume index (odds ratio [OR], 1.02; P < .003), older age (OR, 1.04; P < .001), heart failure (OR, 6.73; P < .001), and sternotomy (OR, 2.19; P < .002). Age, heart failure, and sternotomy were independent predictors of prolonged PAF. Patients with PAF had greater mortality at 3 years compared with those without PAF (5.3% vs 0.5%, P < .005). On multivariable analysis, PAF was associated with increased mortality (hazard ratio, 7.81; P < .046). ConclusionsPAF is common after MVS and associated with late mortality. Older age, advanced heart failure, and sternotomy are associated with prolonged PAF. These factors may identify patients who would benefit from prophylactic LAAA or ablation during MVS.

Polyester microplastic fibers induce mitochondrial damage, apoptosis and oxidative stress in Daphnia carinata, accompanied by changes in apoptotic and ferroptosis pathway

With the widespread utilization of plastic products, microplastics (MPs) have merged as a newfound environmental contaminant in the United States, and the bulk of these MPs in the environment manifest as fibrous structures. Concerns have also been voiced regarding the potential hazards posed by microplastic fibers (MFs). However, research examining the toxicity of MFs, particularly in relation to planktonic organisms, remains severely limited. Meanwhile, polyester fiber materials find extensive applications across diverse industries. As a result, this investigation delved into the toxicology of polyester microplastic fibers (PET-MFs) with a focus on their impact on Daphnia carinata (D. carinata), a freshwater crustacean. Newly hatched D. carinata were subjected to varying concentrations of PET-MFs (0, 50, and 500 MFs/mL) to scrutinize the accumulation of PET-MFs within these organisms and their resultant toxicity. The outcomes revealed that D. carinata was capable of ingesting PET-MFs, leading to diminished rates of survival and reproduction. These effects were accompanied by mitochondrial impairment, heightened mitochondrial count, apoptosis, escalated generation of reactive oxygen species, augmented activity of antioxidant enzymes, and distinct patterns of gene expression. Interestingly, when comparing the group exposed to 50 MFs/mL with the one exposed to 500 MFs/mL, it was observed that the former triggered a more pronounced degree of mitochondrial damage, apoptosis, and oxidative stress. This phenomenon could be attributed to the fact that brief exposure to 500 MFs/mL resulted in greater mortality, eliminating individuals with lower adaptability. Those that survived managed to regulate elevated in vivo reactive oxygen species levels through an increase in glutathione S-transferase content, thereby establishing an adaptive mechanism. Low concentrations did not induce direct mortality, yet PET-MFs continued to inflict harm within the organism. RNA-seq analysis unveiled significant alterations in 279 and 55 genes in the 50 MFs/mL and 500 MFs/mL exposure groups, respectively. Functional enrichment analysis of the 50 MFs/mL group indicated involvement of the apoptosis pathway and ferroptosis pathway in the toxic effects exerted by PET-MFs on D. carinata. This study imparts valuable insights into the toxicological ramifications of PET-MFs on D. carinata, underscoring their potential risks within aquatic ecosystems.

Bacteriological Profile of Surgical Site Infection Following Gastrointestinal Surgery and Their Antibiogram.

Surgical site infection is one of the common complication following abdominal surgery. It causes great morbidity and mortality, further increasing prevalence of multidrug resistant bacteria have made its management very challenging. The current study aims to identify causative agent responsible for surgical site infection and their antibiotic resistance patterns. This study was conducted among patients developing surgical site infection following gastrointestinal surgery in Tribhuvan university teaching hospital over a period of one year. The samples were collected and processed according to standard methods. The bacterial pathogens with their antimicrobial susceptibility were determined and resistant pattern like methicillin resistant Staphylococcus aureus and extended spectrum beta lactamase were further detected. A total of 832 patients had under gone gastrointestinal surgery during the study period. Among them, 162 cases (19.5%) developed surgical site infection and 125 cases showed growth in culture. A total of 160 aerobic bacteria were isolated; Escherichia coli (29.9%) was the commonest organism with 40.8% being extended spectrum beta lactamase producer and 47.4% of Staphylococcus aureus were methicillin resistant. About 75.9% (85/112) of gram negative bacteria and 60.4% (29/48) gram positive bacteria were multi drug resistant. The burden of multi drug resistant bacteria causing surgical site infection is high which needs to be addressed timely. Good surveillance of bacterial antibiogram and rational antimicrobial use is necessary to reduce emergence and spread of resistant bacteria.

44561 Serum C Reactive Protein Levels are Associated with Greater Mortality in Adults with Melanoma

44561 Serum C Reactive Protein Levels are Associated with Greater Mortality in Adults with Melanoma

Central apneas and cardiovascular diseases

Central apneas (CA) and periodic breathing (PB) are the most common related breathing disorders in heart failure, being observed in up to 50% of patients. Once considered only a sleep-related phenomenon, actually CA/PB occur across the whole 24 h period and their presence in the awake patient even in the upright position and during physical effort has been associated with a worse clinical profile and a greater mortality. Chemoreflex activation, circulatory time delay and altered plant gain are the pathophysiological determinants. While the use of guideline-recommended medical and device treatment represents the first step in the management of CA in heart failure patients, no specific therapy has been demonstrated to reduce CA-related impact on mortality. In particular, the use of non-invasive ventilation has yielded contradictory results in the context of large-scale randomized clinical trials. The design and testing of therapies targeting the pathophysiological triggers of CA, such as chemoreflex sensitivity, may prove valuable in the next future.

The Black Death in Hereford, England: A demographic analysis of the Cathedral 14th-century plague mass graves and associated parish cemetery.

This study explores the paleoepidemiology of the Black Death (1348-52 AD) mass graves from Hereford, England, via osteological analysis. Hereford plague mortality is evaluated in the local context of the medieval city and examined alongside other Black Death burials. The Hereford Cathedral site includes mass graves relating to the Black Death and a 12th-16th century parish cemetery. In total, 177 adult skeletons were analyzed macroscopically: 73 from the mass graves and 104 from the parish cemetery. Skeletal age-at-death was assessed using transition analysis, and sex and stress markers were analyzed. The age-at-death distributions for the mass graves and parish cemetery were significantly different (p = 0.0496). Within the mass graves, young adults (15-24 years) were substantially over-represented, and mortality peaked at 25-34 years. From 35 years of age onwards, there was little variation in the mortality profiles for the mass graves and parish cemetery. Males and females had similar representation across burial types. Linear enamel hypoplasia was more prevalent within the mass graves (p = 0.0340) whereas cribra orbitalia and tibial periostitis were underrepresented. Mortality within the Hereford mass graves peaked at a slightly older age than is seen within plague burials from London, but the overall profiles are similar. This demonstrates that young adults were disproportionately at risk of dying from plague compared with other age groups. Our findings regarding stress markers may indicate that enamel hypoplasia is more strongly associated with vulnerability to plague than cribra orbitalia or tibial periostitis.

Domestication of Death : Discourses and Images of Death after the Black Death in Western Medieval Europe

Domestication of Death : Discourses and Images of Death after the Black Death in Western Medieval Europe

Alternative anticoagulation during extracorporeal detoxification

The role of heparin anticoagulation in the development of hemorrhagic syndrome after extracorporeal detoxification (ECD) procedures in patients with initial hemostasis disorders, as well as the place of alternative citrate anticoagulation in extracorporeal treatment have not yet received a final assessment and require further study. The aim of this work was to compare the results of treatment of patients with severe intoxication using heparin and citrate as anticoagulants during ECD procedures. The conducted study confirms that the use of heparin anticoagulation in ECD leads to a spasmodic progression of the manifestations of DIC that were present before the procedure. Citrate anticoagulation demonstrates the benefits consisting in the absence of a spasmodic increase in coagulopathy, hypofibrinemia, and thrombocytopenia during an ECD session, which is characteristic of the heparin use. However, when ECD is initiated against the background of more severe initial coagulopathy and, interrelatedly, more severe multiple organ failure (MOF), this does not improve treatment outcomes. Moreover, among patients with severe MOF taken for ECD, there was a greater mortality rate and a large proportion of deaths during and immediately after the session when using citrate anticoagulation. Thus, ECD procedures with citrate anticoagulation may have a negative impact on the condition of patients who already have severe MOF and severe coagulopathy. This risk may be associated with metabolic disorders, especially dangerous in such severe patients, and does not outweigh the risk of an increase in hemostasis disorders characteristic of heparin anticoagulation. Probably, ECD with citrate anticoagulation has to be carried out at an earlier stage of the disease, and in cases of severe MOF already present in the patient, it is advisable to use traditional heparin anticoagulation.

The Black Death ravaging Europe in the fourteenth century might be the pathogen-driven selective pressure for factor V Leiden

Factor V Leiden as a mutant gene defect of hereditary thrombophilia exists peculiarly in Caucasians but almost absent in people traditionally living in Asia. This lopsided dispensation has persisted as an enigma to be solved. Thus, a hypothesis is raised here that the Black Death, a plague pandemic caused by Yersinia pestis, which ravaged Europe in the fourteenth century and brought on a severe human extermination constituted the pathogenic selective pressure for factor V Leiden of which the procoagulative, anti-fibrinlolysis function, and the resultant resistance potential to Yersinia pestis infection have been demonstrated in a series of animal experiments and clinical observation. The same explanation is also proposed for a similar unbalanced distribution of prothrombin G20210A mutation, another thrombophilia genetic variant, between Caucasians and Asians despite awaiting more solid evidence in the near future. On the other hand, the fact that deficiency of protein C, protein S, and antithrombin had not risen during the plague disaster is theoretically attributed to more severe and fatal disseminated intravascular coagulation associated with the dysfunction of them. The whole assumption implies an underlying evolutionary advantage of factor V Leiden and a mysterious relationship between genetic traits and diseases. It is hoped that future investigations dedicating to analysis of ancient DNA from human remains in the medieval cemeteries before, during, and after the plague will finally let the speculation come true.

A large-scale transcriptional analysis reveals herb-derived ginsenoside F2 suppressing hepatocellular carcinoma via inhibiting STAT3

BackgroundHepatocellular carcinoma (HCC) is a common type of cancer that shows great morbidity and mortality rates. However, there are limited available drugs to treat HCC. AimThe present work focused on discovering the potential anti-HCC compounds from traditional Chinese medicine (TCM) by employing high-throughput sequencing-based high-throughput screening (HTS2) together with the liver cancer pathway-associated gene signature. MethodsHTS2 assay was adopted for identifying herbs. Protein-protein interaction (PPI) network analysis and computer-aided drug design (CADD) were used to identify key targets and screen the candidate natural products of herbs. Molecular docking, network pharmacology analysis, western blotting, immunofluorescent staining, subcellular fractionation experiment, dual-luciferase reporter gene assay, surface plasmon resonance (SPR) as well as nuclear magnetic resonance (NMR) were performed to validate the ability of compound binding with key target and inhibiting its function. Moreover, cell viability, colony-forming, cell cycle assay and animal experiments were performed to examine the inhibitory effect of compound on HCC. ResultsWe examined the perturbation of 578 herb extracts on the expression of 84 genes from the liver cancer pathway, and identified the top 20 herbs significantly reverting the gene expression of this pathway. Signal transducer and activator of transcription 3 (STAT3) was identified as one of the key targets of the liver cancer pathway by PPI network analysis. Then, by analyzing compounds from top 20 herbs utilizing CADD, we found ginsenoside F2 (GF2) binds to STAT3 with high affinity, which was further validated by the results from molecular docking, SPR and NMR. Additionally, our results showed that GF2 suppresses the phosphorylation of Y705 of STAT3, inhibits its nuclear translocation, decreases its transcriptional activity and inhibits the growth of HCC in vitro and in vivo. ConclusionBased on this large-scale transcriptional study, a number of anti-HCC herbs were identified. GF2, a compound derived from TCM, was found to be a chemical basis of these herbs in treating HCC. The present work also discovered that GF2 is a new STAT3 inhibitor, which is able to suppress HCC. As such, GF2 represents a new potential anti-HCC therapeutic strategy.

A Descriptive Study of Workplace Risk Assessment in the Automobile Sector of Uttarakhand, India

Aims: The auto sector in India contributes 7.1% of the country's GDP and is predicted to earn USD 810.3 billion by 2026. However, India has a greater death rate and poorer job safety than the United States, where industrial accidents happen 20 times more frequently. Musculoskeletal disorders are a significant cause of disability and accidents at work. The goal of the study was to evaluate the existing working conditions in the automobile industry, where mechanics play a crucial role in precision.&#x0D; Study Design: The present study was carried out in Uttarakhand at Udham Singh Nagar district, block Rudrapur; Nainital district, block Haldwani; and Almora district, block Dwarahat. Purposive and random sampling techniques were used to select the study area and samples. The total 75 respondents and 14 garages were selected.&#x0D; Methodology: A checklist was developed to get information about the health status of garage workers, awareness of occupational hazards, use of personal protective equipment, risk assessment, and workplace analysis.&#x0D; Results: The study reveals that Udham Singh Nagar garages provide cent per cent PPE to their workers, while Nainital and Almora districts lack proper facilities. Nearly half of workers lack worksite cleaning facilities, slip-resistant floors, spray booths, dip tanks, and clean toilets. Additionally, a quarter of garages require adjustments to work height, foot platforms, item holders, work-rotation systems, hanging toolboxes, and hazardous chemical container labeling.&#x0D; Conclusion: 7.1% of India's GDP is contributed by the auto industry, which is projected to generate $810.3 billion by 2026. In contrast to the US, the nation has a greater fatality rate and a worse level of workplace safety, and industrial accidents happen there 20 times more frequently. According to a survey conducted in Uttarakhand, whereas Nainital and Almora districts lack adequate amenities, Udham Singh Nagar garages offer cent per cent PPE to employees. There aren't enough clean restrooms, or there aren't enough slip-resistant floors for the majority of employees.

The Development of Modern Chinese Medicine in a Comparative Perspective of the History of Chinese and Western Medicine

Chinese and Western medicine have different origins and have developed in different ways and with different contents. This paper focuses on a comparative study of the history of Chinese and Western medicine, tracing the development of ancient Greek medicine, the rescue and treatment of the Black Death in medieval Europe, and the medical treatment and public health represented by the prevention and treatment of smallpox in the Qing Dynasty. Chinese and Western medicine offered different paths to the rescue and treatment of disease from different perspectives. At the same time, the paper focus on the formation and development of the systematization of Chinese and Western medicine in modern times and the transformation of modern Chinese medicine under the influence of Western learning in the east. By discussing the changes in the modern Chinese medical education system - from ecclesiastical medicine to an integrated institutional training model, the further training of medical talents and finally the government's promulgation of the University Decree to provide modern By discussing the changes in the modern Chinese medical education system - from ecclesiastical medicine to an integrated institutional training model for medical personnel and finally the government’s promulgation of the University Decree to provide institutional guarantees for modern medical education, the significance of the convergence of Western and Chinese medicine for the development of modern Chinese medicine will be discussed in this paper.

Therapeutic effects of Stemmoside C against Salmonella enterica serotype typhimurium infected BALB/c mice

Salmonella is a Gram-negative bacterium that causes gastrointestinal diseases in 20 to 40 million people globally. Stemmoside C is a steroidal glycoside isolated from Argel, although its antibacterial and antibiofilm properties have not been studied. The antibacterial activity of Stemmoside C against Salmonella enterica was revealed, where MIC of the compound was 16 μg/mL (0.15 µM). Biofilm-associated Stemmoside C treatment destroyed S. typhi cells and reduced viable S. typhi numbers below detectable levels. When compared to Stemmoside C or Ciprofluxacin-treated mice, infected BALB/c mice had a greater death rate and a larger bacterial blood burden. The protective effects of orally administered Stemmoside C at dose of 25 and 50 mg/kg b.wt. against bacterial infection was associated with reduction in the levels of inflammatory cytokines (IFN-γ, Il-1β, IL-2, IL-6, MPO, and TNF-α) and elevation of anti-inflammatory cytokine (IL-10 and IL-12) in serum. Where, Stemmoside C at dose of 50 mg/kg b.wt. regulated the levels almost as normal control group and demonstrated apparently normal intestinal sections. It also resulted in a decrease in the number of viable S. typhi retrieved from feces. Stemmoside C is a promising drug for the treatment or prevention of S. typhimurium infection.

Illustrations for Our Time

Abstract This article examines how the Black Death is represented visually in the Illustrated Chronicle Compilation (Litsevoi letopisnyi svod), a many-tomed account of the history of Russia compiled and lavishly illustrated at the court of Ivan the Terrible in the 1560s or 1570s. Illustrators and chroniclers depicted ordinary plague victims differently from those of high rank. Lofty individuals, like Grand Prince Semen Ivanovich and his sons, were shown apart from the mass deaths and their deaths were not explicitly attributed to plague. This may be because plague was understood as divine punishment. Nonetheless, the illustrations show the common humanity of plague victims. Illustrators also expressed an appreciation of the organic connections between human and natural spheres and the fragile relations between the two.

Puzzles of the Plague in Rus’

Abstract Recent historical and biological research on the Black Death in the Middle Ages has yielded new finds and spurred new questions. This article investigates how information about the plague in Rus’ lands fits with these emerging paradigms. Building on foundational research by Lawrence N. Langer from the 1970s, the article investigates the origin of the plague in Rus’ lands and its characteristics.

Re-hospitalizations within 30-days and mortality outcomes among severely visually impaired and blind patients: analysis of the National Readmission Database

BackgroundReadmissions and in-hospital mortality among patients with severe vision impairment or blindness (SVI/B) has not been fully studied. We investigated hospital outcomes for adults with SVI/B in the United States.MethodsUsing the Nationwide Readmission Database year 2017, we analyzed primary outcomes for thirty-day readmission rates for patients with and without SVI/B. Secondary outcomes were in-hospital mortality rates for readmitted patients, in-hospital mortality rates for index patients, the five most common principal diagnoses for readmission, and resource utilization.Results34,558 patients had an index admission for SVI/B vs. 24,600,000 who did not. Patients with SVI/B had a 13.3% [4,383] readmission rate within 30 days compared to 8.4% [2,033,329] without SVI/B. Compared to readmitted patients without SVI/B patients, those with SVI/B were older (mean [SD] age: 64.4 [SD ± 19] vs. 61.4 [SD ± 20] years) and had more comorbidities (Charlson comorbidity score ≥ 3: 79.2% [ 3,471] vs. 60.9% [1,238,299]). The mortality rate among patients readmitted with SVI/B was 5.38% [236] vs. 4.02% [81,740] for patients without SVI/B, p-value = 0.016. Top reasons for readmissions among patients with SVI/B included sepsis 12% [526], heart failure 10.5% [460)], acute renal failure 4.4% [193], complications due to type II diabetes mellitus 4.1% [178], and pneumonia 2.7% [118]. The mean length of stay for readmitted patients with SVI/B was 6.3 days (confidence interval [CI]: 6.0-6.7 days), vs. 5.6 days for patients without SVI/B (CI: 5.5–5.8 days), p-value < 0.01. The mean hospital charges for readmitted patients with SVI/B was $57,202 (CI: $53,712–$61,292) vs. $51,582 (CI: $49,966–$53,198), p-value < 0.01.ConclusionPatients with SVI/B had higher readmission rates and greater mortality on readmissions than those without SVI/B. Interventional studies for optimal discharge strategies are critically needed to improve clinical and resource utilization outcomes in patients with SVI/B.

A cross-sectional study of anthropometry and immunization coverage of Anganwadi children in a rural area of Karnataka.

Children are a supreme asset to a nation. Beginning six years of life is pivotal for the social, emotional, cognitive, physical, motor, and psychological upbringing of the child. National Family Health Survey (NFHS) 5 data shows 41.9% of children die before the age of five years, with greater mortality in the rural areas (45.7%). The present study was conducted to assess the anthropometric profile and immunization status of children in Anganwadi centers. A community-based cross-sectional study was conducted in 21 Anganwadi centers in a rural area in South India. The anthropometry (height, weight, mid-upper arm circumference), morbidity profile, and immunization status of the enrolled and available children were assessed with the help of WHO growth charts, Salter scale, clinical examination, immunization cards, and data from Anganwadi registers. Data were compiled and analyzed using SPSS software version 20. Descriptive data were interpreted as mean and percentages and associations were tested with the Chi-square test, and Fisher's exact test. A P value of <0.05 was considered to be statistically significant. Around 400 children, aged 0-6 years, participated in the study. The mean age of the study population was 42.08 ± 12.55 months. The overall prevalence of underweight, stunting, and wasting was 52%, 54%, and 47.5% respectively. The most common morbidity was upper respiratory tract infection (11.5%). A majority (97.5%) of children were found to be immunized appropriately as per age. The prevalence of malnutrition was alarmingly high which warrants urgent referral and follow-up. The ICDS services, although substantially beneficial, need focal strengthening with regard to the nutritional status of enrolled children.

Effects of PKCε knockdown on mitochondrial membrane potential of human glioma cells in vitro and growth of U251 cell-derived tumors in vivo

ABSTRACT Glioma is the most common type of primary brain tumor; it exhibits great invasive capacity, morbidity and mortality. Protein kinase Cε (PKCε), a serine/threonine kinase, contributes to the development and progression of many cancers. We investigated whether knockdown of PKCε could affect the mitochondrial membrane potential of human glioma cell lines, U251 and U87, and the growth of U251 cell-derived tumors in nude mice. We found that the expression of PKCε was greater in human glioma tissues than in human normal brain tissues. Knockdown of PKCε reduced mitochondrial membrane potential in U251 and U87 cells. Knockdown of PKCε also suppressed the growth of tumors derived from U251 cells and induced apoptosis of U251 cells in vivo. Our findings indicate that PKCε is important for development and progression of glioma and may be a potential therapeutic target for glioma treatment.

Age, admission platelet count, and mortality in severe isolated traumatic brain injury: A retrospective cohort study.

We asked whether patients >50 years of age with acute traumatic brain injury (TBI) present with lower platelet counts and whether lower platelet counts are independently associated with mortality. We combined trauma registry and laboratory data on a retrospective cohort of all patients ≥18 years of age admitted to our Level 1 US regional trauma center 2015-2021 with severe (Head Abbreviated Injury Score [AIS] ≥3), isolated (all other AIS <3) TBI who had a first platelet count within 1 h of arrival. Age and platelet count were assessed continuously and as groups (age 18-50 vs. >50, platelet normals, and at conventional transfusion thresholds). Outcomes such as mean admission platelet counts and in-hospital mortality were assessed categorically and with logistic regression. Of 44,056 patients, 1298 (3%, median age: 52 [IQR 33,68], 76.1% male) met all inclusion criteria with no differences between younger and older age groups for (ISS; 18 [14,26] vs. 17 [14,26], p = .22), New ISS (NISS; 29 [19,50] vs. 28 [17,50], p = .36), or AIS-Head (4 [3,5] vs. 4 [3,5]; p = .87). Patients aged >50 had lower admission platelet counts (219,000 ± 93,000 vs. 242,000 ± 76,000/μL; p < .001) and greater in-hospital mortality (24.5% vs. 15.6%, p < .001) than those 18-50. In multivariable regression, firearms injuries (OR9.08), increasing age (OR1.004), NISS (OR1.007), and AIS-Head (OR1.05), and decreasing admission platelet counts (OR0.998) were independently associated with mortality (p < .001-.041). Platelet transfusion in the first 4 h of care was more frequent among older patients (p < .001). Older patients with TBI had lower admission platelet counts, which were independently associated with greater mortality.