Abstract
Background: The present study aims to describe the severity of injury [Glasgow Coma Scale (GCS)] and outcome of patients [Glasgow Outcome Scale (GOS)] who presented to our hospital with TBI and factors which affect the clinical outcome.Subjects and Methods:All patients, aged equal to or more than 18 years, presenting to the Emergency Department of our hospital due to head trauma during the study period were examined and assessed using GCS at the time of admission, and GOS at the time of discharge.Results:The most common mode of injury was road traffic accident (48%). At the time of admission, 47% had GCS of 13 to 15, 37% had GCS of 9 to 12 and 16% had GCS of 3 to 8. At the time of discharge, we found that 18 patients had GOS of 1, no patient had GOS of 2, 14 patients had GOS Of 3, 28 had GOS of 4 and 29 had GOS of 5. We found that age of the patients was significantly associated with the GOS severity (p value <0.05). Furthermore, GCS at admission was found to be significantly associated with GOS at discharge (p value <0.01). Midline shift on CT head, effaced basal cistern, and presence of subarachnoid haemorrhage were also found to be significantly associated with poor GOS at discharge.Conclusion: The results of our study may be used for stratification of patients, and developing prognostic models to improve the clinical outcome of head injury.
Highlights
The World Health Organisation defines Traumatic Brain Injury (TBI) as an occurrence of injury to the head with at least one of the following: observed or self-reported alteration of consciousness or amnesia due to head trauma, neurologic or neuropsychological or diagnoses of skull fracture or intracranial lesions that can be attributed to the head trauma.[1]
The present study aims to describe the severity of injury (GCS) and outcome of patients (GOS) who presented to our hospital with TBI and factors which affect the clinical outcome
At the time of discharge, we found that 18 patients had Glasgow Outcome Scale (GOS) of 1, no patient had GOS of 2, 14 patients had GOS Of 3, had GOS of 4 and had GOS of 5 (Figure 1)
Summary
The World Health Organisation defines Traumatic Brain Injury (TBI) as an occurrence of injury to the head with at least one of the following: observed or self-reported alteration of consciousness or amnesia due to head trauma, neurologic or neuropsychological or diagnoses of skull fracture or intracranial lesions that can be attributed to the head trauma.[1]. An epidemiological study in Bangalore indicates that the incidence, mortality and case fatality rates were 150/1,00,000, 20/1,00,000 and 10%, respectively.[2] The most common cause of TBI normally reported in our country are road traffic accidents (RTA) accounting for 60%, followed by falls and assaults contributing to 25% and 10% of traumatic brain injuries respectively.[2] The Glasgow Coma Scale (GCS) is one of the most commonly used tools by trauma care providers as it enables the gradation of head injury severity using simple observations rather than invasive or specialist techniques. The present study aims to describe the severity of injury (GCS) and outcome of patients (GOS) who presented to our hospital with TBI and factors which affect the clinical outcome. The present study aims to describe the severity of injury [Glasgow Coma Scale (GCS)] and outcome of patients [Glasgow Outcome Scale (GOS)] who presented to our hospital with TBI and factors which affect the clinical outcome. Conclusion: The results of our study may be used for stratification of patients, and developing prognostic models to improve the clinical outcome of head injury
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