Predictors of Outcome in Traumatic Brain Injury.

Predictors of Outcome in Traumatic Brain Injury.

World Neurosurg. 2015 Dec 22;

Authors: Baum J, Entezami P, Shah K, Medhkour A

Abstract
INTRODUCTION: The purpose of this study was to retrospectively evaluate patients treated for traumatic brain injuries (TBI) to determine how multiple organ trauma (MOT) and lung injuries sustained at the time of initial injury affect outcome.
METHOD: A single institution retrospective review of all patients diagnosed with TBI at a level I trauma center from 2000-2014 was conducted. Clinical outcome was based on Glasgow Outcome Scale (GOS) at hospital discharge. Lung injury was defined as the presence of pulmonary contusions, pneumothorax, hemothorax, rib fractures, or diaphragmatic rupture proven by X-ray or CT scan. MOT was defined as trauma to one body region with an AIS score ≥ 3 plus trauma to two additional body regions with AIS scores ≥ 1.Regression analysis was conducted using SPSS 21.
RESULTS: There were 409 patients reviewed. Majority of patients were male (73%), average age was 46y (16-94), average GCS was 7, and 71% had a severe TBI (GCS≤8). Thirty percent of patients had poor outcome (GOS=1-2) Regression analysis indicated age (OR=1.03, p<0.001), initial GCS (OR=0.88, p<0.001), ISS (OR=1.03, p=0.021), and head AIS≥5 (OR=0.55, p=0.019) were significant independent predictors of poor outcome. Sex, MOT, lung injury, and lung injury severity were not significant predictors of outcome.
CONCLUSIONS: Age, GCS, ISS, and critical head injuries (AIS≥5) were significant tools in predicting outcome in this patient cohort. Multiple organ trauma and traumatic lung injury may cause significant damage to a patient suffering from a severe TBI, but these injuries do not predict mortality in this patient population.

PMID: 26721615 [PubMed - as supplied by publisher]

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