medigraphic.com
ISSN 2225-4676 (Electronic)

2013, Number 1

<< Back Next >>

Rev Cubana Neurol Neurocir 2013; 3 (1)

Glasgow coma scale as mortality prognostic factor in severe traumatic brain injury

Hodelín TR, Domínguez PR, Fernández AMA

Language: Spanish
References: 20
Page: 57-62
PDF size: 250.83 Kb.


ABSTRACT

Objective: To identify elements of the Glasgow coma scale the prognostic factor of mortality in patients with severe traumatic brain injury.
Methods: An observational analytic type case–control study was carried out, for the sick persons hospitalized in the Saturnino Lora Provincial Hospital Surgical Clinical in Santiago de Cuba City, during the period of January 2009 to December 2010, with the diagnosis severe traumatic brain injury. They carried out statistical tests like the chi–square, the Odds Radios (OR) test and the logistical regression pattern.
Results: Amongst the prognostic factors that influence the mortality of the severe traumatic brain injury, they were punctuations between 3 and 5 in the Glasgow coma scale, the absence of response to painful stimulus and the bilateral fixed dilated pupils. In the analysis of logistical regression, the variable that explained independently the mortality corresponded between 3 and 5 on the Glasgow coma scale.
Conclusions: The patients with severe traumatic brain injury that presented a Glasgow coma scale from 3 to 5 had greater probability of dying, as well as those with severe traumatic brain injury that don't have motor responses. If they presented with bilateral fixed dilated pupils the probability of dying it rises at the 100%. It is independently evident that the advance in the study of different prognostic factors and in spite of their limitations, the Glasgow coma scale continues to be useful tool to classify and to know the prognostic mortality in patients with severe traumatic brain injury.


REFERENCES

  1. Dubose JJ, Browder T, Inaba K, Teixeira PG, Chan LS, Demetriades D. Effect of trauma center designation on outcome in patients with severe traumatic brain injury. Arch Surgery. 2008;143:1213–7.

  2. Piña Tornés AA, Garcés Hernández R, Velázquez González E, Lemes Báez JJ. Factores pronósticos en el traumatismo craneoencefálico grave del adulto. Rev Cubana Neurol Neurocir. 2012; 2(1):28–33. [citado: 20.10.2012]. Disponible en: http://www.revneuro.sld.cu

  3. Ríos Lago M, Muñoz Céspedes JM, Paúl Lapedriza N. Alteraciones de la atención tras daño cerebral traumático: evaluación y rehabilitación. Rev Neurol. 2007;44(5):291–7.

  4. Mei–Dan O, Carmont MR, Monasterio E. The Epidemiology of Severe and Catastrophic Injuries in BASE Jumping. Clin J Sport Med 2012; 22(3):262–7. [citado: 23.10.2012]. Disponible en: http://preview.ncbi.nlm.nih.gov/pubmed/22450590

  5. Mosquera Betancourt G, Vega Basulto S, Valdeblánquez Atencio J, Varela Hernández A. Protocolo de manejo hospitalario del trauma craneoencefálico en el adulto mayor. Arch Méd Camagüey 2010;14(1). [citado: 13.11.2012]. Disponible en: http://scielo.sld.cu/scielo.php?pid=s102502552010000100014&script=sci_arttext

  6. Hodelín Tablada R. Pacientes en estado vegetativo persistente o estado de mínima conciencia secundarios a traumatismos craneoencefálicos. MEDICIEGO. 2010; 16(Supl. 1). [citado: 24.10.2012]. Disponible en: http://bvs.sld.cu/revistas/mciego/vol16_supl1_10/pdf/t20.pdf

  7. Hodelín Tablada R, Machado Curbelo C. Estado vegetativo persistente. Un nuevo reto para las Neurociencias contemporáneas. Rev Cubana Neurol Neurocir. 2011;1(1):44–51. [citado: 10.11.2012]. Disponible en: http://www.revneuro.sld.cu

  8. Domínguez Peña R, Hodelín Tablada R, Fernández Aparicio M. Factores pronósticos en el traumatismo craneoencefálico grave. MEDICIEGO. 2010; 16(Supl. 1). [citado: 11.11.2012]. Disponible en: http://bvs.sld.cu/revistas/mciego/vol16_supl1_10/pdf/t22.pdf

  9. Domínguez Peña R, Hodelín Tablada R, Fernández Aparicio M. Factores pronósticos de la mortalidad por traumatismos craneoencefálicos graves. MEDISAN. 2011; 15(11):1525–1532. [citado: 25.10.2012]. Disponible en: http://bvs.sld.cu/revistas/san/vol_15_11_11/san041111.pdf

  10. Helmy A, Kirkpatrick PJ, Seeley HM, Corteen E, Menon DK, Hutchinson PJ. Fixed, dilated pupils following traumatic brain injury: historical perspectives, causes and ophthalmological sequelae. Acta Neurochir Suppl. 2012; 114:295–299. [citado: 13.11.2012]. Disponible en: http://preview.ncbi.nlm.nih.gov/pubmed/22327711

  11. MRC CRASH Trial Collaborators, Perel P, Arango M, Clayton T, Edwards P, Komolafe E, et al. Predicting outcome after brain injury: practical prognostic models based on large cohort of international patients. BMJ. 2008; 336(7641):425–429. [citado: 22.10.2012]. Disponible en: http://preview.ncbi.nlm.nih.gov/pubmed?term=%22mrc%20crash%20trial%20collaborators%22%5bcorporate%20author%5d

  12. Marmarou A, Lu J, Butcher I, McHugh GS, Mushkudiani NA, Murray GD, et al. IMPACT Database of Traumatic Brain Injury: design and description. J Neurotrauma. 2007;24(2):239–50. [citado: 22.10.2012]. Disponible en: http://preview.ncbi.nlm.nih.gov/pubmed/17375988

  13. Choi SC, Barnes TY. Predicting outcome in the head–injured patient. En: Narayan RK, Wilberger JE, Povlishock JT (eds). Neurotrauma. New York: McGraw–Hill; 1996: 779–92.

  14. Helmy A, Kirkpatrick PJ, Seeley HM, Corteen E, Menon DK, Hutchinson PJ. Fixed, dilated pupils following traumatic brain injury: historical perspectives, causes and ophthalmological sequelae. Acta Neurochir Suppl 2012; 114:295–299. [citado: 11.11.2012]. Disponible en: http://preview.ncbi.nlm.nih.gov/pubmed/22327711

  15. Poca MA, Sahuquillo J, Baguena M, Pedraza S, Gracia RM, Rubio E. Incidence of intracraneal hipertension after severe head injury. A prospective study using the Traumatic Coma Data Bank classification. Acta Neurochir Suppl. 1998;71:27–30. [citado: 12.11.2012]. Disponible en: http://preview.ncbi.nlm.nih.gov/pubmed?term=20.%09poca%20ma%2c%20sahuquillo%20j%2c%20baguena%20m%2c%20pedraza%20s%2c%20gracia%20rm

  16. Kiboi JG, Kitunguu PK, Angwenyi P, Mbuthia F, Sagina LS. Predictors of functional recovery in African patients with traumatic intracranial hematomas. World Neurosurg. 2011;75(5–6):586–91. [citado: 30.10.2012]. Disponible en: http://preview.ncbi.nlm.nih.gov/pubmed?term=25.%09kiboi%20jg%2c%20kitunguu%20pk%2c%20angwenyi%20p%2c%20mbuthia%20f%2c%20sagina%20l

  17. Bordini A, Liz TF, Fernández M, Arruda WO, Teive HAG. Coma scales: a historical review. Arq Neuro–Psiquiatr. 2010;68(6). [citado: 13.11.2012]. Disponible en: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004–282X2010000600019&lang=pt

  18. Morgado FL, Rossi LA. Correlação entre a escala de coma de Glasgow e os achados de imagem de tomografia computadorizada em pacientes vítimas de traumatismo craneoencefálico. Radiol Bras 2011; 44(1). [citado: 29.10.2012]. Disponible en: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0100–39842011000100010&lang=pt

  19. Costanti Settervall CH, Cardoso de Sousa RM, Fürbringer e Silva SC. In–hospital mortality and the Glasgow Coma Scale in the first 72 hours after traumatic brain injury. Rev. Latino–Am Enfermagem. 2011;19(6). [citado: 11.11.2012]. Disponible en: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0104–11692011000600009&lang=pt

  20. Levi L, Guilburd J, Soustiel J, Sviri G, Constantinescu M, Zaaroor M. Why mortality is still high with modern care of 613 evacuated mass lesions presented as severe head injuries 1999–2009. Acta Neurochir Suppl. 2012;114:301–4. [citado: 13.11.2012]. Disponible en: http://preview.ncbi.nlm.nih.gov/pubmed/22327712




2020     |     www.medigraphic.com