Predictors of Poor Prognosis in the Medium- Term of Traumatic Brain Injury

Noelia Rivas Martínez¹*, Gustavo Rivas Martínez², Sergio Eduardo Giannasi³, Nicolás Marcelo Ciarrocchi³

Received: April 23, 2019;   Published: May 02, 2019

DOI: 10.26717/CTBB.MS.ID.000116

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Abstract

Objectives: The aims of this study are: a) to identify predictors of mid-term poor neurological outcome in Moderate or Severe Traumatic Brain Injury (MoSTBI); b) to recognize the consequences of MoSTBI, using neurological outcome and mortality rates six months after the patient´s discharge from the Intensive Care Unit (ICU).

Methods: Prospective, longitudinal study. Patients with MoSTBI admityted to the ICU of the Manuel Giagni Trauma Hospital (Paraguay) were included. Patient´s family members were contacted by phone six months after ICU discharge to assess survival and neurological outcome, using the Barthel Index.

Main measures: Demographics, Glasgow Coma Scale (GCS) on admission and at ICU discharge, New Injury Severity Score, APACHE II, Marshall CT Score, mechanical ventilation, sedation, ICU length of stay, the development of shock, infectious complications were collected.

Results: At six months after ICU discharge, mortality rate of MoSTBI was 43.9%, while and 57.60% of survivors achieved functional independence. The only predictor of poor neurological outcome was GCS at discharge from ICU (p-=0.003).

Conclusion: The GCS measured at ICU discharge was the best predictor of poor neurological outcome in MoSTBI patients. The measurement of this score once the patient has survived the acute phase could identify those most vulnerable and put in them a greater effort of rehabilitation.

Keywords: Traumatic Brain Injury; Predictors of Poor Prognosis; Disability; Functional Capacity; Mortality Rates; Barthel Index; Neurological Outcome

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