BACKGROUND: We previously demonstrated that @entity542 ( @entity542 ) significantly reduced in-hospital mortality from 19% to 14% in @entity1 with severe @entity131 (sTBI). However, functional and long-term outcomes had not been assessed. We hypothesized that @entity542 would be associated with improved functional and long-term outcomes in sTBI @entity1 . METHODS: All @entity131 @entity1 older than 14 years with a head Abbreviated Injury Scale (AIS) score of 3 or greater were identified from the @entity542 database and matched to the state death index and the regional @entity131 ( @entity131 ) database. Data from 2008 through 2012 were analyzed before and after @entity542 in 2010. For @entity1 discharged to the @entity131 unit, overall @entity177 ( @entity177 ) scores and @entity177 score gains were compared before and after @entity542 . RESULTS: A total of 3,496 @entity1 with sTBI were identified in the @entity542 database, 1,359 in the pre- @entity542 and 2,137 in the post- @entity542 period. The mortality rate after discharge decreased significantly after @entity542 from 21% to 16% (p < 0.0001) at 30 days and from 24% to 20% (p = 0.004) at 6 months. Multivariable logistic regression demonstrated @entity542 to be an independent predictor against mortality at 30 days (odds ratio, 0.74; 95% confidence interval, 0.60-0.91; C statistic, 0.84) and 6 months (odds ratio, 0.82; 95% confidence interval, 0.67-0.99; C statistic, 0.82). Discharges to the @entity131 unit increased from 117 (9%) in the pre- @entity542 to 297 (14%) in the post- @entity542 period (p < 0.0001), while discharges to home and non- @entity131 units remained similar. Injury Severity Score (ISS) and Glasgow @entity772 Scale (GCS) score for all discharged @entity1 remained similar. @entity177 admission scores were similar in the pre- @entity542 (median, 54; interquartile range [IQR], 30-65) and post- @entity542 period (median, 48; IQR, 31-61) (p = 0.2) and remained similar at discharge in the pre- @entity542 (median, 92; IQR, 75-102) and post- @entity542 period (median, 89; IQR, 73-100) (p = 0.1). @entity131 @entity1 showed similar @entity177 score gains in the pre- @entity542 (median, 37; IQR, 26-46) and post- @entity542 period (median, 36; IQR, 24-49) (p = 0.6). CONCLUSION: @entity542 was associated with reduced long-term mortality, increased @entity131 admissions, and similar @entity177 score improvements for @entity1 with sTBI. LEVEL OF EVIDENCE: Therapeutic/care management study, level IV.

Functional and long-term outcomes in severe XXXX following regionalization of a trauma system.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity131 :: ('MESH:D001930', 'Disease') :: ['TBIr', 'TBI', 'TBI rehabilitation', 'traumatic brain injury'] @entity542 :: ('MESH:D006259', 'Disease') :: ['RT', 'regionalization of trauma'] @entity772 :: ('MESH:D003128', 'Disease') :: ['Coma'] @entity177 :: ('MESH:D051437', 'Disease') :: ['FIM', 'Functional Independence Measure']
@entity131 :: (MESH:D001930,Disease) :: ['traumatic brain injury']
