A study of prognostic score for predicting the outcome in cases of traumatic brain injury

Authors

  • Sudhir Singh Pal Department of General Surgery, Gandhi Medical college and Associated Hamidia Hospital, Bhopal, Madhya Pradesh, India
  • Ashay Rathore Department of General Surgery, Gandhi Medical college and Associated Hamidia Hospital, Bhopal, Madhya Pradesh

DOI:

https://doi.org/10.18203/2349-2902.isj20201400

Keywords:

GCS, IMPACT, Traumatic brain injury

Abstract

Background: Glasgow coma scale (GCS) and the Glasgow outcome scale help us with confident predictions after 24 h following the injury, but not on admission. The IMPACT and CRASH studies provided new methods for performing prognostic studies of traumatic brain injury. And this prognostic scoring system has been studied in our study.

Methods: This is an observational prospective cohort study performed at the department of surgery, Gandhi medical college and Hamidia hospital, Bhopal on 87 patients during a period of 2 years. A preformed pro-forma was filled for each patient after 6 hours of resuscitation which included all the details of the patients like name, age, sex, CR no., and GCS after resuscitation, mode of injury, the clinical evaluation score used by IMPACT trial and neurological finding, management details, CT scan was done as soon as possible for all patients and findings were included in the pro-forma. The final outcome was recorded at the time of discharge.

Results: Among Patients with mean total prognostic score of 0-4, 97% patients discharged without deficit, 3% discharged with deficit with no mortality. Among score of 15-20, only 7 % can be discharged without deficit and 7% could be discharged without deficit, while 86 % patient died.

Conclusions: The mean total prognostic score of discharged groups was significantly lower than the patients in discharged group. We concluded that this prognostic model helps us to individually identify patients who will succumb to death and early need for surgical intervention.

Author Biography

Ashay Rathore, Department of General Surgery, Gandhi Medical college and Associated Hamidia Hospital, Bhopal, Madhya Pradesh

Junior resident in department of surgery

References

Steyerberg EW, Mushkudiani N, Perel P, Butcher I, Lu J, Mchugh GS, et al. Predicting outcome after traumatic brain injury: development and international validation of prognostic scores based on admission characteristics. PLoS Med. 2008;5:165.

Gómez PA, Cruz JD, Lora D, Roldán LJ, Boto GR,. Validation of a prognostic score for early mortality in severe head injury cases. J Neurosurg. 2014;121:1314-22.

International mission for prognosis and analysis of clinical trials. Available at tbi.impact.orgdata.gov.in. Accessed on 12 December 2019.

Perel P, Edwards P, Wentz R, Roberts I. Systematic review of prognostic models in traumatic brain injury. BMC Med Inform Decis Mak. 2006;3:77-9.

Pal R, Munivenkatappa A, Agrawal A, Menon GR, Galwankar S. Predicting outcome in traumatic brain injury: sharing experience ofpilot traumatic brain injury registry. Int J Crit Illn Inj Sci. 2016;6(3):127-32.

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Published

2020-03-26

Issue

Section

Original Research Articles