Severe head injuries: An outcome prediction and survival analysis

Abstract

Clinicians can determine the odds of a good outcome from the combination of three easily measurable factors using a simple diagram constructed from logistic regression. Survival analysis showed that motor score adjusted values greater than 3 had the same prognosis.

Indicadores clínicos e pré-hospitalares de sobrevivência no trauma fechado: uma análise multivariada

“…Head and brain injuries' later involvement with deaths and thorax, abdominal, lower limb and external surface injuries' involvement with deaths since the earliest phase until late post-trauma periods were already demonstrated in other studies that used the statistical strategy of survival analysis (6,8) , alerting about the probable association between hemorrhagic causes and negative results until late phases. Researchers (1) affirm that patients with head and brain injuries can benefit from stabilization at the accident scene, particularly from procedures to optimize oxygenation and circulation, which help to prevent secondary injuries due to hypoxia or cerebral edema, delaying death.…”

“…The use of survival analysis can permit this observation, as the dependent variable becomes the time until death, while independent variables are the different factors that can interfere in the occurrence of this event over time (6)(7)(8)(9) . Through this approach, the prognostic indicators related to early or late death can be evidenced according to certain time periods, depending on scientific interest.…”

“…In trauma research, this type of analysis has been used to assess the results of patients with head and brain traumas (6)(7) and severely traumatized patients (8) . In these studies, though, except for intubation at the accident scene, interventions or variables related to the victim's assessment in the prehospital care period were not taken into account.…”

Prehospital treatment of head injuries ‐ can we do better?

“…The severity of the brain injury probably leads to the poor breathing and hypoxia. However, hypoxia itself causes secondary brain injury and has been shown to be a predictor of unfavourable outcome 7 . Prompt reversal of hypoxia should improve the outcome for a particular AIS score.…”

Predeterminantes de sobrevivência em vítimas de acidentes de trânsito submetidas a atendimento pré-hospitalar de suporte avançado à vida

“…(20) A análise da sobrevivência considera o tempo até a ocorrência do evento estudado, como variável dependente e os diversos fatores que podem interferir na ocorrência desse evento, como variáveis independentes. (20,21,22,23,24) Essas variáveis podem ser relativas a características sociodemográficas, as intervenções realizadas ou outras de qualquer ordem, porém, sempre considerando cada espaço de tempo determinado, segundo o interesse científico.…”