{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T14:32:11Z","timestamp":1793197931685,"version":"4.5.0"},"reference-count":35,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T00:00:00Z","timestamp":1792454400000},"content-version":"vor","delay-in-days":19,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Emerg Medicine Australasia"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Although recognised as a leading cause of death and disability, it is unclear whether current treatment strategies have improved outcomes from blunt moderate to severe traumatic brain injuries (msTBI) due to a lack of available epidemiological data. This study sought to determine if in\u2010hospital mortality and early functional outcomes of msTBI patients have changed over 20\u2009years. Early functional outcomes were determined through the surrogate measure of the proportion of patients discharged directly to home.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A longitudinal cohort study using The Alfred Health Trauma Registry data. Subjects were aged 16\u201370\u2009years with blunt msTBI (Head Abbreviated Injury Scale 3\u20135) admitted to The Alfred Trauma Service between 1 January 2002 and 31 December 2021.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 8222 patients presented with msTBI over the period, with 692 deaths (8.5%). Unadjusted in\u2010hospital mortality decreased from 12.1% in 2002 to 4.0% in 2021 (OR 0.96, 95% CI 0.95\u20130.97,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Sensitivity analysis demonstrated a statistically significant reduction in the odds of death even after adjusting for injury severity (OR 0.96, 95% CI 0.93\u20130.99,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001). The proportion of patients discharged to home increased from 30.6% to 60.8% over the period (OR 1.05, 95% CI 1.04\u20131.06,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>There was a reduction in in\u2010hospital mortality and an increase in the proportion discharged home for adults\u00a0hospitalised with msTBI at The Alfred Hospital over the last two decades. These results foster optimism for the care of neurotrauma patients, but further research is required to identify the modifiable factors associated with these improved outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1742-6723.70374","type":"journal-article","created":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T07:30:53Z","timestamp":1792481453000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Moderate and Severe Traumatic Brain Injury Outcomes\u2014A 20\u2009Year (2002\u20132021) Analysis"],"prefix":"10.1111","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-5524-1552","authenticated-orcid":false,"given":"Yuewei","family":"Xiao","sequence":"first","affiliation":[{"name":"National Trauma Research Institute  Melbourne Australia"},{"name":"School of Translational Medicine Monash University  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4063-9581","authenticated-orcid":false,"given":"Yesul","family":"Kim","sequence":"additional","affiliation":[{"name":"National Trauma Research Institute  Melbourne Australia"},{"name":"School of Translational Medicine Monash University  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5763-917X","authenticated-orcid":false,"given":"Gerard","family":"O'Reilly","sequence":"additional","affiliation":[{"name":"National Trauma Research Institute  Melbourne Australia"},{"name":"School of Public Health and Preventive Medicine Monash University  Melbourne Australia"},{"name":"Emergency and Trauma Centre The Alfred Hospital  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3827-9898","authenticated-orcid":false,"given":"Jeffrey V.","family":"Rosenfeld","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery The Alfred Hospital  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madeline","family":"Green","sequence":"additional","affiliation":[{"name":"National Trauma Research Institute  Melbourne Australia"},{"name":"School of Translational Medicine Monash University  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3368-9065","authenticated-orcid":false,"given":"Ron","family":"Jithoo","sequence":"additional","affiliation":[{"name":"National Trauma Research Institute  Melbourne Australia"},{"name":"School of Translational Medicine Monash University  Melbourne Australia"},{"name":"Department of Neurosurgery The Alfred Hospital  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin","family":"Tee","sequence":"additional","affiliation":[{"name":"National Trauma Research Institute  Melbourne Australia"},{"name":"School of Translational Medicine Monash University  Melbourne Australia"},{"name":"Department of Neurosurgery The Alfred Hospital  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noel","family":"Sceriha","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery The Alfred Hospital  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6284-2022","authenticated-orcid":false,"given":"Andrew","family":"Udy","sequence":"additional","affiliation":[{"name":"Department of Intensive Care &amp; 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