Factors Affecting Clinical Outcome of Patients with Traumatic Brain Injury

D. Rajpal, Sachna Pramod Shetty, Manhar Shah
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Abstract

Background: The present study aims to describe the severity of injury [Glasgow Coma Scale (GCS)] and outcome of patients [Glasgow Outcome Scale (GOS)] who presented to our hospital with TBI and factors which affect the clinical outcome.Subjects and Methods:All patients, aged equal to or more than 18 years, presenting to the Emergency Department of our hospital due to head trauma during the study period were examined and assessed using GCS at the time of admission, and GOS at the time of discharge.Results:The most common mode of injury was road traffic accident (48%). At the time of admission, 47% had GCS of 13 to 15, 37% had GCS of 9 to 12 and 16% had GCS of 3 to 8. At the time of discharge, we found that 18 patients had GOS of 1, no patient had GOS of 2, 14 patients had GOS Of 3, 28 had GOS of 4 and 29 had GOS of 5. We found that age of the patients was significantly associated with the GOS severity (p value <0.05). Furthermore, GCS at admission was found to be significantly associated with GOS at discharge (p value <0.01). Midline shift on CT head, effaced basal cistern, and presence of subarachnoid haemorrhage were also found to be significantly associated with poor GOS at discharge.Conclusion: The results of our study may be used for stratification of patients, and developing prognostic models to improve the clinical outcome of head injury.
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影响外伤性脑损伤患者临床预后的因素
背景:本研究旨在描述到我院就诊的TBI患者的损伤严重程度[格拉斯哥昏迷量表(GCS)]和预后[格拉斯哥预后量表(GOS)]以及影响临床预后的因素。研究对象和方法:所有研究期间因头部外伤就诊于我院急诊科的年龄在18岁及以上的患者,在入院时采用GCS,出院时采用GOS进行检查和评估。结果:道路交通事故是最常见的伤害方式(48%)。入院时,47%的患者GCS为13 - 15,37%的患者GCS为9 - 12,16%的患者GCS为3 - 8。出院时GOS为1者18例,GOS为2者无一例,GOS为3者14例,GOS为4者28例,GOS为5者29例。我们发现患者年龄与GOS严重程度有显著相关性(p值<0.05)。入院时GCS与出院时GOS显著相关(p值<0.01)。CT头部中线移位、基底池淡化、蛛网膜下腔出血也与出院时GOS不良显著相关。结论:本研究结果可用于患者分层,建立预后模型,以改善颅脑损伤的临床预后。
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