Long-term survival following traumatic brain injury: A population-based parametric survival analysis

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*Study developed statistical models of life expectancy following acute traumatic brain injury (TBI) to provide predictions of longevity and quantify differences in survivorship with the general population of the United States (US). A population-based retrospective cohort study using data from the Rochester Epidemiology Project (REP) was performed. A random sample of patients from Olmsted County, Minnesota with a confirmed TBI between 1987 and 2000 was identified and vital status determined in 2013. Parametric survival modelling was then used to develop a model to predict life expectancy following TBI conditional on age at injury. Survivorship following TBI was also compared with the general population and age- and gender-matched non-head injured REP controls. Seven hundred sixty nine patients were included in complete case analyses. The median follow-up time was 16.1 years with 120 deaths occurring during the study period. Survival after acute TBI was well represented by a Gompertz distribution. Victims of TBI surviving for at least 6 months after injury demonstrated a much higher ongoing mortality rate compared to the US general population and non-TBI controls. US general population cohort life table data was used to update the Gompertz model’s shape and scale parameters to account for cohort effects and allow prediction of life expectancy in contemporary TBI. Findings suggest survivors of TBI have decreased life expectancy compared to the general population. This may be secondary to the head injury itself or result from patient characteristics associated with both the propensity for TBI and increased early mortality.

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