End Points of Traumatic Brain Injury Resuscitation

Abstract

Severe traumatic brain injury (TBI) is an insult severe enough to cause an acute and persistent loss of consciousness with a significant risk of death or disability. Worldwide, it is a leading cause of death, especially for younger people less than 50 years of age. Over the last two decades, we have made significant progress in our understanding of the pathophysiology of TBI. This however has not resulted in substantial improvements in outcome, as the incidence of TBI continues to increase and mortality rates remain relatively unchanged. To better understand the long-term outcome and end points in TBI resuscitation, tools to predict a patient’s prognosis becomes essential. In this review, we discuss the role of clinical assessment, as such the Glasgow Coma Scale and the Full Outline of UnResponsiveness Score, neuroimaging, including computed tomography (CT) and MRI, and current research innovations, such as the biomarkers, to predict TBI outcomes. Additionally, we describe the clinical implications of using prognostic models, such as the International Mission on Prognosis and Analysis of Clinical Trials in TBI (IMPACT) database models and the Corticosteroid Randomization after Significant Head Injury (CRASH) trial data models to calculate TBI outcome.