2023 American Academy of Neurology Abstract Website

Objective:

We aim to find the incidence of PE in traumatic brain injury (TBI) and the impact of comorbidities on the development of PE.

Background:

Deep venous thrombosis (DVT), often prodromal for pulmonary embolism (PE) causes significant morbidity and mortality.Understanding factors contributing to PE in TBI patients can help better control the outcomes in this population.

Design/Methods:

This is a retrospective study of inpatient subjects from 2016-2020 with TBI collected from the Healthcare Cost and Utilization Project (HCUP). The cohort was dichotomized to the presence or absence of PE, and were evaluated for demographics, types of TBI, and comorbidities. Regression statistical analysis was conducted to find the odds of developing PE in TBI.

Results:

During five years study period, we studied 206,708 TBI cases, of which 1324 developed PE (0.65%) and 3584 developed DVT (1.8%). The cohort was composed mostly of white (71.5%), and males (60%) with a mean age of 64.8 y/o. Most types of TBIs were subdural hematoma (49.3%). The patients who developed PE were younger (61.1 vs. 64.9, p<0.001), male (66.9%, p<0.001), had longer hospital stays (18.4 vs 6.9 d, p<0.001), and had significantly higher mortality (13,7% vs. 8.1%, p<0.001).

In Multivariate analysis, having DVT (OR.9.85, 95% CI [5.5-17.6], p<0.001), COPD (OR, 1.33, 95% CI[ 1.08-1.64], p=0.009) and Renal disease (OR 1.3 , 95%CI[ 1.3-1.5], p<0.001) and black race (OR1.27, 95%CI[ 1.07-1.5], p=0.006) had the highest impact on developing PE. Of the different types of TBI, Epidural hemorrhage had the most effect on developing PE (OR. 1.43, 95%CI [ 1.01-2.02],p=0.04).

Conclusions:

Our data shows the incidence of PE and DVT in TBI is low; however, it's lethal with a high LOS. The incidence of PE is higher in Blacks and in those with DVT, COPD, and Renal failure. Among different types of TBI, Epidural hematoma has the highest association with the development of PE.