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Original ArticleOpen Access
Risk Factors for Mortality in Head-Injured Patients with Probability of Survival Greater Than 0.5
Wipassakornwarawut S 
,
Suwonmontri P ,
Thokaow S
,
Suwonmontri P ,
Thokaow S Background: Traumatic brain injury is one of the major problems and leading cause of death worldwide. The present study
was aimed to identify factors responsible for mortality by comparing survivors and nonsurvivors in patients that had a low
probability of mortality.
Material and Method: A nested case-control study was conducted at Sawanpracharak Hospital from January 1, 2007 to
December 31, 2007. All head injury deaths that had TRISS-PS greater than 0.5 were enrolled as the “case” patients. Head
injured patients with TRISS-PS greater than 0.5 and that survived were chosen as the “control” patients. The number of
controls per case was 2:1. Patients with ages < 15 were excluded from the present study.
Results: Six factors associated with increased mortality are age > 45 years (OR = 1.61, 95% CI = 1.1-2.3), alcohol
intoxication (OR = 3.11, 95% CI = 1.4-6.9), admission GCS 3-8 (OR = 4.16, 95% CI = 2.4-7.2), arrival GCS-M < 4
(OR = 1.46, 95% CI = 1.0-2.0), Head-AIS > 4 (OR = 3.31, 95% CI = 1.3-8.3), and admission SBP < 90 mmHg (OR = 13.36,
95% CI = 3.2-56.3).
Conclusion: Head injury continues to be a substantial public health problem. Deaths that met criteria for low probability of
mortality, especially in those without associated risk factors should be analyzed for errors that may be preventable.
Keywords: Traumatic brain injury, TRISS-derived Probability of survival, Risk factor, Mortality
was aimed to identify factors responsible for mortality by comparing survivors and nonsurvivors in patients that had a low
probability of mortality.
Material and Method: A nested case-control study was conducted at Sawanpracharak Hospital from January 1, 2007 to
December 31, 2007. All head injury deaths that had TRISS-PS greater than 0.5 were enrolled as the “case” patients. Head
injured patients with TRISS-PS greater than 0.5 and that survived were chosen as the “control” patients. The number of
controls per case was 2:1. Patients with ages < 15 were excluded from the present study.
Results: Six factors associated with increased mortality are age > 45 years (OR = 1.61, 95% CI = 1.1-2.3), alcohol
intoxication (OR = 3.11, 95% CI = 1.4-6.9), admission GCS 3-8 (OR = 4.16, 95% CI = 2.4-7.2), arrival GCS-M < 4
(OR = 1.46, 95% CI = 1.0-2.0), Head-AIS > 4 (OR = 3.31, 95% CI = 1.3-8.3), and admission SBP < 90 mmHg (OR = 13.36,
95% CI = 3.2-56.3).
Conclusion: Head injury continues to be a substantial public health problem. Deaths that met criteria for low probability of
mortality, especially in those without associated risk factors should be analyzed for errors that may be preventable.
Keywords: Traumatic brain injury, TRISS-derived Probability of survival, Risk factor, Mortality
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