Association between Outcome of Severe Traumatic Brain Injury and Demographic, Clinical, Injury‑related Variables of Patients

Marzieh Ziaeirad, Nasrollah Alimohammadi, Alireza Irajpour, Bahram Aminmansour

Abstract


Background: Traumatic brain injury (TBI) is a main health problem among communities. There exists a variety of effective factors on the outcome of patients with TBI. We describe the demographic, clinical, and injury related variables of the patients with severe TBI, and determine the predictors of outcome.

Materials and Methods: We did this cross‑sectional study on all 267 adult patients with severe TBI admitted to three trauma centers of Isfahan University of Medical Sciences (IUMS) from March 20, 2014 to March 19, 2015. Data were extracted from patients’ profiles. We considered the patients’ outcome as discharged and died. We analyzed the collected data using descriptive (frequency, mean, and standard deviation) and analytical (independent t‑test, Mann– Whitney U‑test, Kruskal–Wallis test and logistic regression) statistics in Statistical Package for the Social Sciences (SPSS) 16.0. We considered p < 0.05 as the significance level.

Results: The mean (SD) age of patients was 43.86 (18.40) years. The majority of the population was men (87.27%). Road traffic accidents (RTAs) were the most common mechanism of trauma (79.40%). The mean (SD) of Glasgow coma scale (GCS) was 6.03 (3.11). In 50.19% of the patients, the pupillary reflex was absent. One hundred and twenty‑four patients (46.44%) died before discharge. We found age, gender, GCS, pupillary reflex, hypernatremia, and increased intracranial pressure (IICP) as the predictors of death in severe TBI.

Conclusions: In this study, the mortality rate of patients with severe TBI was high. In addition, some factors were determined as the significant predictors of outcome. The findings can assist in planning to enhance the quality of care and reduce the mortality rate in the patients with severe TBI.


Keywords


Head trauma, Iran, patients, traumatic brain injury

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References


Imen RB, Olfa C, Kamilia C, Meriam B, Hichem K, Adel C, et al. Factors predicting early outcome in patients admitted at emergency department with severe head trauma. J Acute Dis 2015;4:68‑72.

Atci IB, Yilmaz H, Kara D, Yilmaz N, Bitlisli H, Ayden O, et al. Retrospective analysis of 3524 head trauma patients admitted to the emergency department as epidemiological approach to head traumas in our region. Acta Med Mediterranea 2015;31:825‑8.

Haller CS, Walder B. Severe neurotrauma in Switzerland: Have short‑term outcomes improved? Swiss Med Wkly 2015;145:w14177.

Collaborators MC, Perel P, Arango M, Clayton T, Edwards P, Komolafe E, et al. Predicting outcome after traumatic brain injury: Practical prognostic models based on large cohort of international patients. BMJ 2008;336:425‑9.

Damkliang J, Considine J, Kent B. Thai emergency nurses management of patients with severe traumatic brain injury: Comparison of knowledge and clinical management with best available evidence. Australas Emerg Nurs J 2013;16:127‑35.

Hejini ES, Hadavi M. Assessment of epidemiology of traumatic brain injuries and its consequences in Rafsanjan: A descriptive study. Community Health J 2015;9:37‑46.

Zand S, Rafiei M. Causes and duration of hospitalization and mortality rate in intensive care units in central province. J Crit Care Nurs 2010;3:7‑8.

Hijar M, Perez‑Nunez R, Inclan‑Valadez C, Silveira‑Rodrigues EM. Road safety legislation in the Americas. Rev Panam Salud Publica 2012;32:70‑6.

Whyte J, Gosseries O, Chervoneva I, DiPasquale M, Giacino J, Kalmar K, et al. Predictors of short‑term outcome in brain‑injured patients with disorders of consciousness. Prog Brain Res 2009;177:63‑72.

Grigorakos L, Alexopoulou A, Tzortzopoulou K, Stratouli S, Chroni D, Papadaki E, et al. Predictors of outcome in patients with severe traumatic brain injury. J Neurosci Clin Res 2016;1:1.

Saini NS, Rampal V, Dewan Y, Grewal SS. Factors predicting outcome in patients with severe head injury: Multivariate analysis. Indian J Neurotrauma 2012;9:45‑8.

Baum J, Entezami P, Shah K, Medhkour A. Predictors of outcomes in traumatic brain injury. World Neurosurg 2016;90:525‑9.

Kasmaei VM, Asadi P, Zohrevandi B, Raouf MT. An epidemiologic study of traumatic brain injuries in emergency department. Emerg (Tehran) 2015;3:141‑5.

Roozenbeek B, Maas AI, Menon DK. Changing patterns in the epidemiology of traumatic brain injury. Nat Rev Neurol 2013;9:231‑6.

Brazinova A, Rehorcikova V, Taylor MS, Buckova V, Majdan M, Psota M, et al. Epidemiology of traumatic brain injury in Europe: A living systematic review. J Neurotrauma 2016.

Peeters W, van den Brande R, Polinder S, Brazinova A, Steyerberg E, Lingsma H, et al. Epidemiology of traumatic brain injury in Europe. Acta Neurochir 2015;157:1683‑96.

Guerrier G, Morisse E, Barguil Y, Gervolino S, Lhote E. Severe traumatic brain injuries from motor vehicle‑related events in New Caledonia: Epidemiology, outcome and public health consequences. Aust N Z J Public Health 2015;39:188‑91.

Settervall CH, Sousa RM, Silva SC. In‑hospital mortality and the Glasgow Coma Scale in the first 72 hours after traumatic brain injury. Rev Lat Am Enfermagem 2011;19:1337‑43.

Chalya PL, Gilyoma JM, Dass RM, Mchembe MD, Matasha M, Mabula JB, et al. Trauma admissions to the intensive care unit at a reference hospital in Northwestern Tanzania. Scand J Trauma Resusc Emerg Med 2011;19:1‑7.

Haji Maghsoudi M, Akhlaghi SM, Nikouyeh M, Dehghani MH, Ahmadi SV, Hosseini SM. The role of safety equipment in reduction of head and face injuries in motorcycle and car accidents. J Safety Promot Injury Prev 2016;4:33‑8.

Modaghegh MHS, Saremi E, Mohamadian M, Jafarzadeh R. Characteristics of trauma in North East Iran and the prevention strategies. Arch Iran Med 2013;16:576‑9.

Ebrahimi FH. The outcome of patients hospitalized with severe head injury in Vali‑asr hospital according to Glasgow Coma Scale in 2005‑06. Arak Med Univ J 2010;12:1‑9.

Fazel M, Fakharian E, Tabesh H, Forghani Z, Yegane Moghadam A, Musavi G. Frequency and ethiology of traumatic brain injuries in Kashan hospitals. Feyz J Kashan Univ Med Sci 2007;12:21‑6.

Georgoff P, Meghan S, Mirza K, Stein SC. Geographic variation in outcomes from severe traumatic brain injury. World Neurosurg 2010;74:331‑45.

Fabbri A, Servadei F, Marchesini G, Stein S, Vandelli A. Early predictors of unfavorable outcome in subjects with moderate head injury in the emergency department. J Neurol Neurosurg Psychiatry 2008;79:567‑73.

Iba J, Tasaki O, Hirao T, Mohri T, Yoshiya K, Hayakawa K, et al. Outcome prediction model for severe traumatic brain injury. Acute Med Surg 2014;1:31‑6.

Kulesza B, Nogalski A, Kulesza T, Prystupa A. Prognostic factors in traumatic brain injury and their association with outcome. J Pre‑Clinical Clin Res 2015;9:163‑6.

Leong BK, Mazlan M, Abd Rahim RB, Ganesan D. Concomitant injuries and its influence on functional outcome after traumatic brain injury. Disability Rehabil 2013;35:1546‑51.


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