Abstract
Background: Polytrauma is a term used to describe the patients those are severely injured associated with other injuries (i.e. two or more severe injuries in at least two areas of the body), less often with a multiple injury (i.e. two or more severe injuries in one body area). More than 40% of the patient of Traumatic Brain Injury (TBI) dies due to extra cranial causes. We hypothesized that extra cranial injuries with polytrauma may alter TBI outcomes and perform the study. Materials and methods: An analytical study was done with the patient of moderate to severe head injury admitted to neurosurgery Intensive Care Unit (ICU) of Manipal Teaching Hospital in between January to December 2019. The objective of the study was to assess the impact of concomitant extra cranial injury (Polytrauma) in the outcome of Moderate to severe head injury. Results: In our study it is seen that, those individuals who have presented delayed in emergency department from the time of incidence under the influence of alcohol, likewise with mean Glasgow Coma Scale (GCS) below 8.16+/-3.22 and abnormal pupils, high injury severity score (ISS), and with polytrauma have poorer outcomes. Conclusion: Concomitant extra cranial injuries, injury severity score(ISS),injuries associated under the influence of alcohol, delayed presentation in emergency after incident, GCS below 9 during presentation in ER and abnormal pupils during examinations are the strong predicting factors for the poor outcome of patient with traumatic brain injury.
Highlights
Mechanism of injuries, and associated injuries, clinical features (GCS, Injury Severity Score (ISS), and Abbreviated Injury Score (AIS)) were collected. Patient of both gender and age above 18 years were included in the study and those with inadequate records or who left against advice or were referred to other centers, those who died in emergency department before reaching to neurosurgical Intensive Care Unit (ICU) were excluded from the study
Among them 84 patients fulfilled the inclusion criteria, whereas 24 patients went against medical advice, 17 were discharged on request, 11 were referred to other center for the need of intervention from other specialty. 40 patients were excluded from the study as they did not fulfill the inclusion criteria
We defined polytrauma as any extra cranial injuries with AIS >/= 3.80.95% of the patients in our study who presented with traumatic brain injury with or without polytrauma were male with mean age of 39-41+/-19-20 years
Summary
Polytrauma is a term used to describe the patients those are severely injured associated with other injuries (i.e. two or more severe injuries in at least two areas of the body), less often with a multiple injury (i.e. two or more severe injuries in one body area).More than 40% of the patient of Traumatic Brain Injury (TBI) dies due to extra cranial causes. We hypothesized that extra cranial injuries with polytrauma may alter TBI outcomes and perform the study. The objective of the study was to assess the impact of concomitant extra cranial injury (Polytrauma) in the outcome of Moderate to severe head injury. Results: In our study it is seen that, those individuals who have presented delayed in emergency department from the time of incidence under the influence of alcohol, likewise with mean Glasgow Coma Scale (GCS) below 8.16+/-3.22 and abnormal pupils, high injury severity score (ISS), and with polytrauma have poorer outcomes. Conclusion: Concomitant extra cranial injuries, injury severity score(ISS),injuries associated under the influence of alcohol, delayed presentation in emergency after incident, GCS below 9 during presentation in ER and abnormal pupils during examinations are the strong predicting factors for the poor outcome of patient with traumatic brain injury
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