Kumar, Raj
(2018)
Acute inflammation and infection: the effects on recovery following moderate-to-severe traumatic brain injury.
Doctoral Dissertation, University of Pittsburgh.
(Unpublished)
Abstract
Current thinking by Traumatic Brain Injury (TBI) researchers and clinicians has devolved from the idea that TBI is an event with a finite recovery period, and have shifted to considering TBI a chronic disease with long-term implications for health. Therefore, there is great interest in determining acute biological and clinical factors that influence long-term health and function after injury. This interest drives the two central themes of this dissertation, to better understand: 1) the continuum of TBI disability from acute to chronic recovery; 2) the effects of non-neurological factors on recovery from TBI. Notably, the availability of data that spans the TBI disability continuum—from early stages post-injury to death—is sparse. Aim 1 of this dissertation explains a probabilistic marching procedure used to merge two databases, the National Trauma Databank and TBI Model Systems, which creates an infrastructure to examine the long-term effects of relevant acute care variables. In aim 2, the merged dataset is leveraged to assess the negative effects of acute care hospital-acquired pneumonia (HAP) on long-term global disability and health care utilization. HAP is one example of a non-neurological factor that impacts TBI recovery. Aim 3 focuses on two systemic markers of inflammation and hormone dysfunction, tumor necrosis factor-alpha (TNFα) and estradiol (E2), and assesses their inter-relationship acutely after injury, and their temporal relationship to mortality. The public health implications of the work herein provide observational data to better understand the continuum of TBI disability, and major non-neurological contributors to recovery from injury.
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Details
| Item Type: |
University of Pittsburgh ETD
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| Status: |
Unpublished |
| Creators/Authors: |
|
| ETD Committee: |
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| Date: |
26 September 2018 |
| Date Type: |
Publication |
| Defense Date: |
14 July 2018 |
| Approval Date: |
26 September 2018 |
| Submission Date: |
17 July 2018 |
| Access Restriction: |
No restriction; Release the ETD for access worldwide immediately. |
| Number of Pages: |
115 |
| Institution: |
University of Pittsburgh |
| Schools and Programs: |
School of Public Health > Epidemiology |
| Degree: |
PhD - Doctor of Philosophy |
| Thesis Type: |
Doctoral Dissertation |
| Refereed: |
Yes |
| Uncontrolled Keywords: |
Traumatic Brain Injury; Epidemiology; Neuroepidemiology; Inflammation; Hospital-acquired Pneumonia |
| Date Deposited: |
26 Sep 2018 15:08 |
| Last Modified: |
26 Sep 2018 15:08 |
| URI: |
http://d-scholarship.pitt.edu/id/eprint/34913 |
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