Prognostic factors in traumatic brain injury and their association with outcome
Bartłomiej Kulesza 1, Adam Nogalski 2, Tomasz Kulesza 1, Andrzej Prystupa 3 1 - Department of Trauma Surgery and Emergency Medicine, Medical University of Lublin, Poland 2 - Department of Trauma Surgery and Emergency Medicine, Medical University of Lublin, Pola 3 - Department of Internal Medicine, Medical University of Lublin, Poland JPCCR 2015; 9 (2): ICID: 1186499 Article type: Review article
Introduction. Traumatic brain injuries (TBI) are a real social problem, with an upward trend worldwide. TBI is the leading cause of death and disability, especially among young men. Each year in Europe, and also in Poland, 243 per 100,000 individuals suffer from TBI. Assessing prognosis after traumatic brain injury is very important in order to help clinicians to make a decision about the implementation of specific methods of treatment, and to make communication with the patient and the patient’s family easier. Objective. The objective of this review was to present prognostic factors, to assess outcomes within a short time after a moderate to severe traumatic brain injury, as well as to predict functional outcome. The most important independent variables were: age, Glasgow Coma Scale (GCS) motor score, pupil response, Marshall CT classification and traumatic subarachnoid haemorrhage. Other important prognostic factors included hypotension, hypoxia, glucose, coagulopathy, haemoglobin and category of CT characteristic, such as midline shift, mass lesion, basal cistern. Conclusions. Gender and intraventricular haemorrhage did not have predictive value. This subject needs much more research in the area of new prognostic factors which would be better associated with outcome after traumatic brain injury.