ABSTRACT

After traumatic brain injury (TBI), the detrimental effects extend not only to brain tissue but to other systems as well. The incidence of systemic (extracranial) complications is reported to be high, particularly in severe TBI patients. Up to 89% of severe TBI patients experience impairment of at least one systemic organ system.The mortality rate of severe TBI patients with 1, 2, and 3 organ system failures were 40%, 47%, and 100% compared with 26% of those without organ system failure. These data imply that systemic complications are greatly influential in determining TBI patient outcomes. Therefore, prevention, early detection, and prompt intervention of potential systemic adverse events are essential for reducing morbidity and mortality. This chapter discusses systemic complications of renal (ie, acute kidney injury), hematologic (ie, anemia, coagulopathy), and gastrointestinal (GI) systems (ie, stress-ulcer-related GI bleeding, altered gastric emptying, diarrhea, and constipation) including incidence, pathophysiology, mechanisms, etiologies, and practical management.