Predicting Traumatic Brain Injury Outcomes: The Intersection of Clinical Signs, Laboratory Indicators and Radiology.

OBJECTIVE

Our primary objective was to evaluate various factors (clinical, radiological and laboratory) associated with poor outcome in traumatic brain injury (TBI) patients. We studied 80 TBI patients in this prospective observational study and were followed for 6 months to assess their Glasgow Outcome Scale (GOS).

METHODS

Admission pulse rate, blood pressure, saturation, Glasgow Coma Scale (GCS), pupillary reactivity, non-contrast computerized tomography head and laboratory parameters like hemogram, blood gas analysis, blood glucose were studied and correlated with outcome (Intensive care unit mortality). Data was analyzed using χ2 test and Haldane-Anscombe correction. The p-value of less than 0.05 or 0.01 was considered as significant.

RESULTS

Mean age of patients suffering from TBI was 41 years with male predominance (7:1). Univariate analysis showed hypoxemia, tachycardia, low GCS, non-reacting pupils, hypernatremia and Marshall grade IV was associated with poor outcomes (p<0.05). Multivariate analysis showed low GCS, non-reacting pupils and hypoxemia as major determinants of poor outcome. Low GCS also correlated with prolong hospital stay and poor GOS (I-III).

CONCLUSION

The strong statistical significance of oxygen saturation, low GCS, non-reacting pupils, tachycardia, hypernatremia and Marshall grade IV underscores the critical importance of preventing secondary brain injury and triage in TBI patients.