Correlation among the GCS Score, CT Scan Findings and Early Clinical Outcome of Traumatic Brain Injury- Study of Fifty Cases

Ahmed Sami-Al-Hasan, Koushik Sikder, Md. Rashidul Hoq, Md.Reazul Alam, Md. Mosharraf Hossain
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Abstract

Traumatic brain injury (TBI) is defined as an assault to the brain caused by an external physical force that may produce a state of diminished or altered consciousness and consequently, affecting cognitive abilities or physical function. According to the GCS, traumatic brain injuries are classified as mild, moderate or severe. Currently the imaging method of choice for the diagnosis and prognosis of TBI is CT scan. According to the disease profile in SBMCH about 30% patient is admitted in surgery ward in every admission due to traumatic injury. Out of them about 10% have traumatic head injury. The aim of the study was to evaluate an association among the GCS score, CT scan findings and clinical outcome of head injury. It is a prospective observational study at Sher-E-Bangla Medical college Hospital, Barisal. In this study 72% patients were with no CT scan findings (haemorrhagic / nonhaemorghagic). Rest of the patients had CT scan findings (intracerebral haemorrhage, extradural haematoma, subdural hematoma etc.). In severe TBI there was a significant increase in the incidence of CT findings, with a rate of 100% of abnormalities. In this study it was observed that, on admission patients with low GCS (severe TBI) deteriorate more in comparison to moderate and mild TBI on admission. This association is significant (p = .049). Patients in the severe TBI group (according to GCS) showed the highest mortality (2 out of 5). This association is also statistically significant (p = .002).
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50例外伤性脑损伤GCS评分、CT表现与早期临床转归的相关性研究
外伤性脑损伤(TBI)被定义为由外部物理力引起的对大脑的攻击,可能导致意识减少或改变,从而影响认知能力或身体功能。根据GCS,创伤性脑损伤分为轻度、中度和重度。目前诊断和预后TBI的首选影像学方法是CT扫描。根据SBMCH的疾病概况,每次住院患者中约有30%因创伤性损伤而入住外科病房。其中大约10%的人有创伤性头部损伤。该研究的目的是评估GCS评分、CT扫描结果和头部损伤临床结果之间的关系。这是Barisal Sher-E-Bangla医学院医院的一项前瞻性观察研究。在这项研究中,72%的患者没有CT扫描发现(出血性/非出血性)。其余患者CT表现为脑出血、硬膜外血肿、硬膜下血肿等。在严重的TBI中,CT表现的发生率显著增加,异常率为100%。在这项研究中观察到,入院时低GCS(严重TBI)患者比入院时中度和轻度TBI恶化更多。这种关联是显著的(p = 0.049)。严重TBI组(根据GCS)的患者死亡率最高(2 / 5)。这种关联也具有统计学意义(p = 0.002)。
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