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Acute inflammation and infection: the effects on recovery following moderate-to-severe traumatic brain injury

Kumar, Raj (2018) Acute inflammation and infection: the effects on recovery following moderate-to-severe traumatic brain injury. Doctoral Dissertation, University of Pittsburgh. (Unpublished)

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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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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Kumar, Rajrak119@pitt.edurak119
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairRosano, CaterinaRosanoC@edc.pitt.educar2350
Committee MemberBrooks, Mariabrooks@edc.pitt.edumbrooks
Committee MemberAnthony, Fabioanthony.fabio@pitt.eduanthony.fabio
Committee MemberWagner, Amywagnerak@upmc.eduakw4
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


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