Predicting outcomes 3 months after traumatic brain injury in patients admitted to emergency department

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Published: Sep 11, 2019
DOI: https://doi.org/10.18051/UnivMed.2019.v38.147-155 Universa Medicina
Abstract Viewed: 455
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Keywords:
Traumatic brain injury prognosis emergency mortality trauma

Main Article Content

Ehsan Bolvardi
Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical sciences, Mashhad, Iran.
Maryam Ahmadzadeh
Department of Emergency Medicine, Emergency Medicine Specialist, Mashhad University of Medical sciences, Mashhad, Iran
Hamideh Feiz Disfani
Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical sciences, Mashhad, Iran.
Fariborz Rezaeitalab
Department of Neurology, Faculty of Medicine, Mashhad University of Medical sciences, Mashhad, Iran.
Yalda Ravanshad
Assistant Professor, Clinical Research Development Center, Mashhad University of Medical Sciences, Mashhad, Iran.
Mahdi Foroughian
Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical sciences, Mashhad, Iran.

Abstract

Background
Traumatic brain injury (TBI) is among the leading causes of mortality and long-term disability. Prognosis assessment is a primary factor of clinical decision-making by emergency physicians. This study aimed to investigate the prognostic factors of TBI in the patients admitted to a typical emergency department.

Methods
This prospective cohort study was conducted involving 100 TBI patients. Baseline characteristics, including age, gender, Glasgow Coma Scale (GCS), and vital signs were recorded. Blood tests and brain CT scans were collected. The patients were followed-up three months after the date of admission. The observed outcomes were categorized as recovery without complication, recovery with complication, or death. Statistical analysis was performed using the simple and multivariate binary logistic regression in the software IBM SPSS version 19.

Results
The most common brain CT scan findings were subarachnoid hemorrhage (21.0%) and epidural hemorrhage (20.0%). In the follow-up performed three months after the admission, 47 patients (47.0%) had died, 39 (39.0%) were suffering from complications, and 14 patients (14.0%) were recovering without complications. Simple binary logistic regression showed that older age (OR=3.28, 95% C.I.=1.27-8.41), minor/moderate head trauma (OR=13.93, 95% C.I.=1.73-112.11), severe head trauma (OR=54.40, 95% C.I.=5.71-517.56) and presence of deep skull fracture (OR=8.92, 95% C.I.=1.04-75.53) were statistically significant predictors of mortality. Multivariate logistic regression showed that mortality chance was higher in elderly (OR=7.45, 95% C.I.=2.02-27.36), minor/moderate head trauma (OR=26.87, 95% C.I.=2.42-298.25) and severe head trauma (OR=127.97, 95% C.I.=9.11-1796.28).

Conclusion
This study demonstrated that severe head trauma was the most predicted risk factor of poorer clinical outcomes after TBI.

Article Details

How to Cite
Bolvardi, E., Ahmadzadeh, M., Feiz Disfani, H., Rezaeitalab, F., Ravanshad, Y., & Foroughian, M. (2019). Predicting outcomes 3 months after traumatic brain injury in patients admitted to emergency department. Universa Medicina, 38(3), 147–155. https://doi.org/10.18051/UnivMed.2019.v38.147-155
Issue
Vol. 38 No. 3 (2019)
Section
Original Articles

The journal allows the authors to hold the copyright without restrictions and allow the authors to retain publishing rights without restrictions.

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