Clinical Outcomes of Diffuse Axonal Injury According to Radiological Grade

Lee, Hak-Jae; Sun, Hyun-Woo; Lee, Jae-Seok; Choi, Nak-Joon; Jung, Yoon-Joong; Hong, Suk-Kyung

doi:10.20408/jti.2018.31.2.51

Cited by 8 publications

(5 citation statements)

References 15 publications

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“…Also, in the present study, the hemoglobin level was equal to 12.28 (1.32), while in the study by Lee et al, it was equal to 12.99. 2.30 (g/dL) (40), which is consistent with the results of the present study.…”

Section: Discussionsupporting

confidence: 93%

Evaluation of Laboratory Variables Related to Diffuse Axonal Injury: A Cross-sectional Study

Hatefi

Komlakh

2022

Arch Neurosci

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Background: Diffuse axonal injury (DAI) is an injury that occurs after the onset of traumatic brain injury (TBI), leading to many problems for patients and imposing high costs on the treatment system. Objectives: This study was conducted to investigate the status of laboratory variables in patients with DAI. Methods: This cross-sectional study included 140 patients. Data collection tools were a demographic profile form and magnetic resonance imaging (MRI). Laboratory tests, including glucose, LDL-C, HDL-C, total cholesterol, triglycerides, Hb, HCT, PT, PTT, INR, BUN, creatinine, and CRP were evaluated. Also, specialized devices were used to study the laboratory and radiology variables. Results: Most (61.5%) of the patients were male, 47.1% had a non-governmental occupation, and 55.7% were less than 30 years old. Also, in 87.9% of cases, traffic accidents were the cause of DAI and in 65% of patients, the Glasgow Coma Scale (GCS) was less than 7. In all the laboratory variables differences were observed between the experimental and the control groups. Conclusions: The laboratory variables in patients with DAI had a statistically significant difference compared to the case group, which indicates the negative effect of DAI on laboratory variables. Further studies are required to confirm our results.

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Section: Discussionsupporting

confidence: 93%

Evaluation of Laboratory Variables Related to Diffuse Axonal Injury: A Cross-sectional Study

Hatefi

Komlakh

2022

Arch Neurosci

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“…Moreover, a difference in the rate of tracheostomy (P = 0.03) and hospital-acquired infection (P = 0.04) was observed according to DAI grad- ing. In the study by Lee et al [10], the tracheostomy rate increased according to DAI grading, which is similar to the results of this study.…”

Section: Discussionsupporting

confidence: 92%

Clinical outcomes of diffuse axonal injury after traumatic brain injury according to magnetic resonance grading

Lee

Park

Jeong

et al. 2021

J Korean Soc Geriatr Neurosurg

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Diffuse axonal injury (DAI) occurs in approximately 40% to 50% of patients with severe traumatic brain injury (TBI) [1][2][3][4]. DAI is a shear injury caused by mechanical force and occurs as axial damage [5,6]. DAI contributes to increasing the duration of unconsciousness, mortality, and disability in patients with TBI [2,7]. Identifying DAI in patients with TBI helps predict the recovery of consciousness and clinical outcomes [2][3][4]8]. Furthermore, patients with DAI are often accompanied by damage in other body parts and mixed with several forms of intracranial hemorrhage in a complicated state. For these reasons, the outcome of patients with Objective: Diffuse axonal injury (DAI) is a severe form of traumatic brain injury (TBI) caused by shearing damage to the axons of long connecting fibers. In this study, we evaluated the clinical features according to DAI grading and identified prognostic factors. Methods: The study involved patients diagnosed with DAI using magnetic resonance imaging within 2 weeks of being hospitalized for TBI from January 2019 to December 2019. Patients who received surgical treatments, such as craniectomy or craniotomy for hematoma evacuation or an external ventricular drain, were excluded. To determine prognostic factors, we retrospectively reviewed the demographic, clinical, and radiological characteristics of 41 patients. Patients' outcomes were analyzed using the Glasgow Outcome Scale within 6 months of the traumatic injury. Results: Using a multivariate logistic regression model, unfavorable outcomes were significantly associated with lower Glasgow Coma Scale score (P=0.03), DAI grade III (P=0.03), DAI located at the stem (P=0.04), and the presence of 7 or more DAIs (P=0.03). However, DAI grade II was not a significant prognostic factor (P=0.76). Furthermore, the rates of hospital-acquired infection (P=0.04) and tracheostomy (P=0.03) significantly increased according to DAI grade. Conclusion:Our results provide valuable information on prognostic predictors in patients with TBI.

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“…[13] While most prognostic studies focused on post-discharge outcomes, several studies showed that diffuse axonal injury and brainstem lesions on inpatient MRI were associated with increased duration and intensity of inpatient care as well as poor functional status at discharge. [20][21][22][23] In contrast, the mechanisms by which diagnostic information obtained from MRI may alter patient management and improve the mortality rate in TBI patients remain unclear. Previously, Fiser et al evaluated 40 hospitalized acute TBI patients to find that addition of MRI did not led lead to change in patient management despite detection of more injuries.…”

Section: Discussionmentioning

confidence: 99%

Use of Magnetic Resonance Imaging in Acute Traumatic Brain Injury Patients is Associated with Lower Inpatient Mortality

Lee

Yang

et al. 2021

JCIS

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Objectives: While magnetic resonance imaging (MRI) has higher sensitivity than computed tomography for certain types of traumatic brain injury (TBI), it remains unknown whether the increased detection of intracranial injuries leads to improved clinical outcomes in acute TBI patients, especially given the resource requirements involved in performing MRI. We leveraged a large national patient database to examine associations between brain MRI utilization and inpatient clinical outcomes in hospitalized TBI patients. Material and Methods: The National Inpatient Sample database was queried to find 3,075 and 340,090 hospitalized TBI patients with and without brain MRI, respectively, between 2012 and 2014 in the United States. Multivariate regression analysis was performed to independently evaluate the association between brain MRI utilization and inpatient mortality rate, complications, and resource requirements. Results: The MRI group had a lower unadjusted mortality rate of 0.75% compared to 2.54% in the non-MRI group. On multivariate regression analysis, inpatient brain MRI was independently associated with lower mortality (adjusted OR 0.32, 95% CI 0.12–0.86), as well as higher rates of intracranial hemorrhage (adjusted OR 2.20, 95% CI 1.27–3.81) and non-home discharge (adjusted OR 1.33, 95% CI 1.07–1.67). Brain MRI was independently associated with 3.4 days (P < 0.001) and $8,934 (P < 0.001) increase in the total length and cost of hospital stay, respectively. Conclusion: We present the first evidence that inpatient brain MRI in TBI patients is associated with lower inpatient mortality, but with increased hospital resource utilization and likelihood of non-home discharge.

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Clinical Outcomes of Diffuse Axonal Injury According to Radiological Grade

Cited by 8 publications

References 15 publications

Evaluation of Laboratory Variables Related to Diffuse Axonal Injury: A Cross-sectional Study

Evaluation of Laboratory Variables Related to Diffuse Axonal Injury: A Cross-sectional Study

Clinical outcomes of diffuse axonal injury after traumatic brain injury according to magnetic resonance grading

Use of Magnetic Resonance Imaging in Acute Traumatic Brain Injury Patients is Associated with Lower Inpatient Mortality

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