Outcome measures for traumatic brain injury

Shukla, Dhaval; Devi, Bhagavatula Indira; Agrawal, Amit

doi:10.1016/j.clineuro.2011.02.013

Cited by 156 publications

(121 citation statements)

References 42 publications

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“…It is likely that this difference may have occurred due to the restricted sample studied and may indicate the need to use more sensitive instruments such as Functional Independence Measure (FIM), the Glasgow Outcome Scale Extended (GOSE), and the Disability Rating Scale (DRS) 23,28,29,30 . Limitations of this study must be borne in mind when interpreting these results and for designing future studies on QOL after TBI.…”

mentioning

confidence: 99%

Predictors of quality of life after moderate to severe traumatic brain injury

Weber

Guimarães

Pontes-Neto

et al. 2016

Arq. Neuro-Psiquiatr.

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Objective To verify correlations between age, injury severity, length of stay (LOS), cognition, functional capacity and quality of life (QOL) six months after hospital discharge (HD) of victims of traumatic brain injury (TBI). Method 50 patients consecutively treated in a Brazilian emergency hospital were assessed at admission, HD and six months after HD. The assessment protocol consisted in Abbreviated Injury Scale, Injury Severity Score, Glasgow Coma Scale (GCS), Revised Trauma Score (RTS), Mini Mental Test, Barthel Index and World Health Organization QOL - Brief. Results Strong negative correlation was observed between LOS and GCS and LOS and RTS. An almost maximal correlation was found between RTS and GCS and functional capacity and GCS at HD. Age and LOS were considered independent predictors of QOL. Conclusion Age and LOS are independent predictors of QOL after moderate to severe TBI.

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confidence: 99%

Predictors of quality of life after moderate to severe traumatic brain injury

Weber

Guimarães

Pontes-Neto

et al. 2016

Arq. Neuro-Psiquiatr.

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“…[1] Although the mortality of TBI has decreased substantially in recent years the disability due to TBI has not appreciably reduced. [2] The present study discusses the role of glasgow outcome scale at the time of discharge to predict outcome in patients of traumatic brain injury who were followed up after decompressive craniectomy and provides a baseline data in this sub-group of patients and also provides an opportunity to further explore the role of glasgow coma scale to follow up the patients with severe head injuries as a whole. Glasgow outcome scale (GOS) a five-point scale was proposed by Jennett in 1975 to assess the outcome of comatose patients after TBI and one of the oldest and most widely implemented of the outcome measures.…”

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confidence: 99%

“…The majority of patients (70%) with a severe TBI will fall into the two extremes: those with good recovery and those who die. [2] Although the GOS has been utilized extensively, it has been criticized as suffering from ceiling effects and being insufficiently sensitive to subtle but functionally limiting deficits in cognition, mood and behavior. [5] Dichotomization of GOS scores is usually performed for clinical reasons and for simplicity of interpreting the difference of outcomes between two trial arms and the use of a dichotomized GOS lacks precision.…”

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confidence: 99%

“…[5] Dichotomization of GOS scores is usually performed for clinical reasons and for simplicity of interpreting the difference of outcomes between two trial arms and the use of a dichotomized GOS lacks precision. [2] To overcome the poor precision of GOS various outcome scales have been proposed since 1981 to assess disability following TBI. [6–8] A few, commonly used are GOS with or without extended scores, Disability Rating Scale, Functional Independence Measure, Community Integration Questionnaire, and the Functional Status Examination.…”

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confidence: 99%

“…[6–8] A few, commonly used are GOS with or without extended scores, Disability Rating Scale, Functional Independence Measure, Community Integration Questionnaire, and the Functional Status Examination. [2] Nevertheless, the use of GOS has been cited in the neurotrauma literature on more than several hundred occasions, and it remains the most widely used and accepted instrument available. [9] Standardized inpatient protocol on monitoring, intervention, and outcome recording should be adopted to make future comparisons more useful and to promote benchmarking between trauma centers in order to improve care for patients with severe traumatic brain injury.…”

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confidence: 99%

See 2 more Smart Citations

What′s New in Emergencies Trauma and Shock? Studying glasgow outcome scores at discharge and final outcomes in severe head injury

Agrawal

2012

J Emerg Trauma Shock

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Effect of Out-of-Hospital Tranexamic Acid vs Placebo on 6-Month Functional Neurologic Outcomes in Patients With Moderate or Severe Traumatic Brain Injury

Rowell

Meier

McKnight

et al. 2020

JAMA

218

246

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IMPORTANCE Traumatic brain injury (TBI) is the leading cause of death and disability due to trauma. Early administration of tranexamic acid may benefit patients with TBI.OBJECTIVE To determine whether tranexamic acid treatment initiated in the out-of-hospital setting within 2 hours of injury improves neurologic outcome in patients with moderate or severe TBI. DESIGN, SETTING, AND PARTICIPANTS Multicenter, double-blinded, randomized clinical trial at 20 trauma centers and 39 emergency medical services agencies in the US and Canada from May 2015 to November 2017. Eligible participants (N = 1280) included out-of-hospital patients with TBI aged 15 years or older with Glasgow Coma Scale score of 12 or less and systolic blood pressure of 90 mm Hg or higher. INTERVENTIONS Three interventions were evaluated, with treatment initiated within 2 hours of TBI: out-of-hospital tranexamic acid (1 g) bolus and in-hospital tranexamic acid (1 g) 8-hour infusion (bolus maintenance group; n = 312), out-of-hospital tranexamic acid (2 g) bolus and in-hospital placebo 8-hour infusion (bolus only group; n = 345), and out-of-hospital placebo bolus and in-hospital placebo 8-hour infusion (placebo group; n = 309). MAIN OUTCOMES AND MEASURESThe primary outcome was favorable neurologic function at 6 months (Glasgow Outcome Scale-Extended score >4 [moderate disability or good recovery]) in the combined tranexamic acid group vs the placebo group. Asymmetric significance thresholds were set at 0.1 for benefit and 0.025 for harm. There were 18 secondary end points, of which 5 are reported in this article: 28-day mortality, 6-month Disability Rating Scale score (range, 0 [no disability] to 30 [death]), progression of intracranial hemorrhage, incidence of seizures, and incidence of thromboembolic events. RESULTS Among 1063 participants, a study drug was not administered to 96 randomized participants and 1 participant was excluded, resulting in 966 participants in the analysis population (mean age, 42 years; 255 [74%] male participants; mean Glasgow Coma Scale score, 8). Of these participants, 819 (84.8%) were available for primary outcome analysis at 6-month followup. The primary outcome occurred in 65% of patients in the tranexamic acid groups vs 62% in the placebo group (difference, 3.5%; [90% 1-sided confidence limit for benefit, −0.9%]; P = .16; [97.5% 1-sided confidence limit for harm, 10.2%]; P = .84). There was no statistically significant difference in 28-day mortality between the tranexamic acid groups vs the placebo group (14% vs 17%; difference, −2.9% [95% CI, −7.9% to 2.1%]; P = .26), 6-month Disability Rating Scale score (6.8 vs 7.6; difference, −0.9 [95% CI, −2.5 to 0.7]; P = .29), or progression of intracranial hemorrhage (16% vs 20%; difference, −5.4% [95% CI, −12.8% to 2.1%]; P = .16).CONCLUSIONS AND RELEVANCE Among patients with moderate to severe TBI, out-of-hospital tranexamic acid administration within 2 hours of injury compared with placebo did not significantly improve 6-month neurologic outcome as measured by the Glasgow Ou...

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Outcome measures for traumatic brain injury

Cited by 156 publications

References 42 publications

Predictors of quality of life after moderate to severe traumatic brain injury

Predictors of quality of life after moderate to severe traumatic brain injury

What′s New in Emergencies Trauma and Shock? Studying glasgow outcome scores at discharge and final outcomes in severe head injury

Effect of Out-of-Hospital Tranexamic Acid vs Placebo on 6-Month Functional Neurologic Outcomes in Patients With Moderate or Severe Traumatic Brain Injury

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