Prognostic value of various intracranial pathologies in traumatic brain injury.
Objective: Various intracranial pathologies in traumatic brain injury (TBI) can help to predict patient outcomes. These pathologies can be categorised using the Marshall Classification or the Abbreviated Injury Scale (AIS) dictionary or can be described through traditional descriptive terms such as...
| Publicado en: | European Journal of Trauma & Emergency Surgery Vol. 38; no. 1; pp. 25 - 33 |
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| Autores principales: | , , , |
| Formato: | tables/charts Journal Article |
| Publicado: |
Springer Nature
Feb2012
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=104528700&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 104528700 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 18639933 3C05 jtl: European Journal of Trauma & Emergency Surgery issn: 18639933 maglogo: N pubinfo: dt: Feb2012 vid: 38 iid: 1 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 104528700 72339444 10.1007/s00068-011-0167-5 104528700 ppf: 25 ppct: 8 formats: fmt: @attributes: type: P tig: atl: Prognostic value of various intracranial pathologies in traumatic brain injury. aug: au: Lesko, M. Bouamra, O. O'Brien, S. Lecky, F. affil: Manchester Academic Health Science Centre, The Trauma Audit and Research Network (TARN), Salford Royal NHS Foundation Trust, University of Manchester, Salford M6 8HD UK sug: subj: Brain Injuries Prognosis Brain Pathology Brain Injuries Physiopathology ab: Objective: Various intracranial pathologies in traumatic brain injury (TBI) can help to predict patient outcomes. These pathologies can be categorised using the Marshall Classification or the Abbreviated Injury Scale (AIS) dictionary or can be described through traditional descriptive terms such as subarachnoid haemorrhage (SAH), subdural haemorrhage (SDH), epidural haemorrhage (EDH) etc. The purpose of this study is to assess the prognostic value of AIS scores, the Marshall Classification and various intracranial pathologies in TBI. Methods: A dataset of 802 TBI patients in the Trauma Audit and Research Network (TARN) database was analysed using logistic regression. First, a baseline model was constructed with age, Glasgow Coma Scale (GCS), pupillary reactivity, cause of injury and presence/absence of extracranial injury as predictors and survival at discharge as the outcome. Subsequently, AIS score, the Marshall Classification and various intracranial pathologies such as haemorrhage, SAH or brain swelling were added in order to assess the relative predictive strength of each variable and also to assess the improvement in the performance of the model. Results: Various AIS scores or Marshal classes did not appear to significantly affect the outcome. Among traditional descriptive terms, only brain stem injury and brain swelling significantly influenced outcome [odds ratios for survival: 0.17 (95% confidence interval [CI]; 0.08-0.40) and 0.48 (95% CI; 0.29-0.80), respectively]. Neither haemorrhage nor its subtypes, such as SAH, SDH and EDH, were significantly associated with outcome. Adding AIS scores, the Marshall Classification and various intracranial pathologies to the prognostic models resulted in an almost equal increase in the predictive performance of the baseline model. Conclusions: In this relatively recent dataset, each of the brain injury classification systems enhanced equally the performance of an early mortality prediction model in traumatic brain injury patients. The significant effect of brain swelling and brain stem injury on the outcome in comparison to injuries such as SAH suggests the need to improve therapeutic approaches to patients who have sustained these injuries. pubtype: Academic Journal doctype: tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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