Glasgow Coma Scale score at intensive care unit discharge predicts the 1-year outcome of patients with severe traumatic brain injuryReportar como inadecuado




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European Journal of Trauma and Emergency Surgery

, Volume 39, Issue 3, pp 285–292

First Online: 05 March 2013Received: 21 August 2011Accepted: 10 February 2013

Abstract

ObjectiveTo analyse the association between the Glasgow Coma Scale GCS score at intensive care unit ICU discharge and the 1-year outcome of patients with severe traumatic brain injury TBI.

DesignRetrospective analysis of prospectively collected observational data.

PatientsBetween 01-2001 and 12-2005, 13 European centres enrolled 1,172 patients with severe TBI. Data on accident, treatment and outcomes were collected. According to the GCS score at ICU discharge, survivors were classified into four groups: GCS scores 3–6, 7–9, 10–12 and 13–15. Using the Glasgow Outcome Scale GOS, 1-year outcomes were classified as -favourable- scores 5, 4 or -unfavourable- scores <4. Factors that may have contributed to outcomes were compared between groups and for favourable versus unfavourable outcomes within each group.

Main resultsOf the 538 patients analysed, 308 57 % had GCS scores 13–15, 101 19 % had scores 10–12, 46 9 % had scores 7–9 and 83 15 % had scores 3–6 at ICU discharge. Factors significantly associated with these GCS scores included age, severity of trauma, neurological status GCS, pupils at admission and patency of the basal cisterns on the first computed tomography CT scan. Favourable outcome was achieved in 74 % of all patients; the rates were significantly different between GCS groups 93, 83, 37 and 10 %, respectively. Within each of the GCS groups, significant differences regarding age and trauma severity were found between patients with favourable versus unfavourable outcomes; neurological status at admission and CT findings were not relevant.

ConclusionThe GCS score at ICU discharge is a good predictor of 1-year outcome. Patients with a GCS score <10 at ICU discharge have a poor chance of favourable outcome.

KeywordsTraumatic brain injury Severe Glasgow Coma Scale score Glasgow Outcome Scale score Long-term outcomes  Download fulltext PDF



Autor: J. Leitgeb - W. Mauritz - A. Brazinova - M. Majdan - I. Janciak - I. Wilbacher - M. Rusnak

Fuente: https://link.springer.com/



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