Factors predicting outcome in patients with severe head injury: Multivariate analysis

Saini, Navdeep; Rampal, Vikas; Dewan, Yashbir; Grewal, Sarvpreet Singh

doi:10.1016/j.ijnt.2012.04.009

Cited by 19 publications

(22 citation statements)

References 25 publications

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“…Navdeep Singh Saini et al studied factors predicting outcome in patients with severe head injury, where the majority of patients with road traffic accidents (83.64%) is the most common mode of head injury. 14 In a study done by Fabiana Lenharo Morgado et al on the correlation between Glasgow Coma Scale and cranial computed tomographic findings in patients with traumatic brain injury observed the most common causes of head injury were automobile accidents (52.9%), falls (20.6%), pedestrian injuries (10.8%), falls to the ground (7.8%) and aggression (6.9%). 13 It was observed that majority of patients presented with vomiting (67.20%) followed by loss of consciousness (38.74%).…”

Section: Discussionmentioning

confidence: 98%

“…13 Navdeep Singh Saini et al studied factors predicting outcome in patients with severe head injury, where the majority of patients were males (85.45%). 14 Aiman Mohammed Imtiaz et al studied importance of computed tomography scans in acute traumatic brain injury and observed out of 100 cases included in the study 72% were males, while females constituted only 28%. 15 In a study done by Ali Jafari Khalilabadi et al on the relationship between CT scan findings, level of consciousness and outcome score in patients with traumatic brain haemorrhage observed out of 100 patients 36 were females and 64 were males with average age of 37 years.…”

Section: Discussionmentioning

confidence: 99%

“…This increase in unfavourable outcome with greater degree of midline shift is statistically important with p value < 0.005. 14 Imaging is an important clinical tool used in the management of patients with TBI. Abnormal neurological examination is the most important criterion available to select patients for emergency CT. CT scanning is the primary modality of choice in the diagnostic workup of patients with acute traumatic brain injury for identification of various intracranial consequences, especially within 48 hours which helps in the initial assessment, treatment planning and follow-up and long-term management of patients.…”

Section: Discussionmentioning

confidence: 99%

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Correlation of Computerised Tomography Scan Findings With the Level of Consciousness in Acute Head Trauma

Raje¹,

Patil²,

Chotai³

et al. 2018

jemds

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BACKGROUND Trauma is one of the most common causes of death and lifelong disability in early decades of life, of which majority of cases are neurological trauma. TBI is becoming the most common and devastating problem due to exponential growth in population and increased vehicle use. Head injuries due to road traffic accidents (RTA) are the second most common cause of death, only next to cancer. The present study was observational, prospective study undertaken to evaluate the correlation between CT scan findings and level of consciousness in patients following acute craniocerebral trauma. The aim of this study is to correlate the CT scan findings and level of consciousness and to observe the outcome of the patient with single and multiple lesions. MATERIALS AND METHODS The study was conducted in Department of Neurosurgery, Krishna Medical College and Hospital. All the patients presenting to the hospital with history of head injury and admitted to Department of Neurosurgery were included as study population. Of all patients admitted with head injury and polytrauma, a careful history was collected from the patient and/or attendants to reveal the mechanism of injury and the severity of trauma. The patients were then assessed clinically to evaluate their general condition and the local injury. Glasgow coma scale, Glasgow outcome score and CT findings were evaluated. Statistical analysis-The statistical analysis was performed using the Statistical Package for Social Sciences (SPSS) version 21 for Windows. RESULTS It was observed that majority of patients were in the age group of 21-40 years (55.65%) followed by 41-60 years (20%). The majority of patients were males (71.43%) and females were 28.57%. Patients had higher RTA incidences (72.40%) followed by fall (22.22%) and assault (5.38%). In the clinical findings, majority of patients presented with vomiting (67.20%) followed by loss of consciousness (38.74%). The other clinical presentation includes ENT bleeding (24.46%) and convulsion (18.34%). The history of alcohol consumed was given by 23.48% of patients. It was observed that majority of patients were having abnormal CT findings (80.74%) and only 19.26% patients had normal CT findings. The most common brain lesion among patients was cerebral contusion (46.74%) followed by subdural haematoma (22.11%), inter-parenchymal haematoma (12.34%), subarachnoid haemorrhage (14.17%), skull fractures (8.06%) and midline shift (30.28%). It was observed that majority of patients had mild injury (73.72%) followed by severe type (16.34%) and moderate injury among 174 (9.94%) patients. According to outcome of brain injury, the majority of patients had good recovery (73.89%). The death was observed among 198 (11.31%) patients. It was observed that epidural haematoma, subdural haematoma, inter-parenchymal haematoma, SAH and IVH showed statistically significant relation with level of consciousness, (p < 0.05). It was observed that pneumocephaly and midline shift showed statistically significant relation with level of consciousness (p ...

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Correlation of Computerised Tomography Scan Findings With the Level of Consciousness in Acute Head Trauma

Raje¹,

Patil²,

Chotai³

et al. 2018

jemds

View full text Add to dashboard Cite

show abstract

“…This important investigation in trauma patients needs to be timely. CT scans help guide early operative intervention, which is significantly associated with favourable outcomes, in particular for severe head injury . Delay in CT scan can delay interventions such as surgery in head injury patients and worsen outcomes.…”

Section: Discussionmentioning

confidence: 99%

Improving emergency department trauma care in Fiji: Implementing and assessing the trauma call system

Raj

Creaton

Phillips

2019

Emerg Medicine Australasia

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Objective: The trauma team process was recently implemented at the Colonial War Memorial (CWM) Hospital, Suva. This study audits the trauma call procedure at the hospital over a period of 12 months. Method: Retrospective descriptive study of trauma calls from August 2015 to July 2016 at CWM Hospital. Data relating to patient demographics, time of presentation, time to team assembly and time to computed tomography (CT) scan were extracted from the ED trauma call database. Disposition from the ED and status at hospital discharge was extracted from the hospital patient information system. Results: There were 38 trauma calls for 46 patients. Seventy-two per cent were male. Eighty-two per cent occurred when the CT radiographer was off site (16.00-08.00 h), including 47% that occurred between midnight and 08.00 h. Fifty-two per cent of patients were intubated, 43% went to ICU, 26% went directly to the operating theatre, and 37% died. Benchmarks for time to trauma team assembly and time to CT scan were met in 50% of cases. Conclusion: This was a severely injured cohort of patients with a high mortality rate. The rate of missed calls was not assessed in this study. Time to CT scan could be improved with an onsite radiographer. Time to team assembly could be improved with trauma team training and early notification from pre-hospital providers. There is a need to continue to monitor and refine the trauma call process and to extend data capture to measure injury severity and outcomes.

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“…Commonly used predictors of outcome include Age, Glasgow Coma Scale (GCS), pupillary reaction, brainstem reflexes and CT findings 8,9 . Neurological status at the time of admission is most important factor for prediction of outcome of patient.…”

Section: Introductionmentioning

confidence: 99%

Clinical Evaluation and Management Outcome of Extradural Haematoma

Badhe

Bhamre

2018

MVP Journal of Medical Sciences

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Aims and Objective: The purpose of this study was to evaluate the clinical presentation of patient with extradural hematoma secondary to head injury and to decide upon the mode of management and also to study the results of the management and the outcome and the factors affecting morbidity and mortality. Materials and Methods: Data was collected through a prescribed proforma from the patients admitted in Surgery Department, Dr. Vasantrao Pawar Medical College and Hospital, Adgaon with extradural hematoma during the period of November 2014 to October 2016. The sample size of the study was 30 patients who completed the inclusion and exclusion criteria. All the patients with head injury on CT scan diagnosed to have EDH were included in the study. The management includes conservative measures and/or surgical intervention. The patients were followed for the results during the period of stay in hospital. Results: Temporo-Parietal (20%) and temporal region (20%) was the most common location of EDH. The most significant factors which influences surgical mode of management were higher age group, lower GCS and CT scan variables. Lower GCS was very significantly associated with unfavorable outcome along with CT scan variables irrespective of mode of management. Conclusion: From this study we concluded that neurological status of patient on presentation and the volumetric details of EDH are the most important factors in management and outcome of EDH. EDH patients were managed surgically and carried high number of unfavorable outcome previously. With early detection and treatment due to better connectivity of patients to hospitals, with the help of CT scan and good hospital care, we can expect a decrease in the number of unfavorable outcomes.

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Factors predicting outcome in patients with severe head injury: Multivariate analysis

Cited by 19 publications

References 25 publications

Correlation of Computerised Tomography Scan Findings With the Level of Consciousness in Acute Head Trauma

Correlation of Computerised Tomography Scan Findings With the Level of Consciousness in Acute Head Trauma

Improving emergency department trauma care in Fiji: Implementing and assessing the trauma call system

Clinical Evaluation and Management Outcome of Extradural Haematoma

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