Abstract
ObjectiveTo analyse the association between the Glasgow Coma Scale (GCS) score at intensive care unit (ICU) discharge and the 1-year outcome of patients with severe traumatic brain injury (TBI).DesignRetrospective analysis of prospectively collected observational data.PatientsBetween 01/2001 and 12/2005, 13 European centres enrolled 1,172 patients with severe TBI. Data on accident, treatment and outcomes were collected. According to the GCS score at ICU discharge, survivors were classified into four groups: GCS scores 3–6, 7–9, 10–12 and 13–15. Using the Glasgow Outcome Scale (GOS), 1-year outcomes were classified as “favourable” (scores 5, 4) or “unfavourable” (scores <4). Factors that may have contributed to outcomes were compared between groups and for favourable versus unfavourable outcomes within each group.Main resultsOf the 538 patients analysed, 308 (57 %) had GCS scores 13–15, 101 (19 %) had scores 10–12, 46 (9 %) had scores 7–9 and 83 (15 %) had scores 3–6 at ICU discharge. Factors significantly associated with these GCS scores included age, severity of trauma, neurological status (GCS, pupils) at admission and patency of the basal cisterns on the first computed tomography (CT) scan. Favourable outcome was achieved in 74 % of all patients; the rates were significantly different between GCS groups (93, 83, 37 and 10 %, respectively). Within each of the GCS groups, significant differences regarding age and trauma severity were found between patients with favourable versus unfavourable outcomes; neurological status at admission and CT findings were not relevant.ConclusionThe GCS score at ICU discharge is a good predictor of 1-year outcome. Patients with a GCS score <10 at ICU discharge have a poor chance of favourable outcome.
Highlights
During the last 10 years, the International Neurotrauma Research Organization (INRO; based in Vienna, Austria, founded in 1999) has coordinated a number of projects which focused on the treatment of patients with severe traumatic brain injury (TBI)
The Glasgow Coma Scale (GCS) score at intensive care unit (ICU) discharge is a good predictor of 1-year outcome
Patients with a GCS score \10 at ICU discharge have a poor chance of favourable outcome
Summary
During the last 10 years, the International Neurotrauma Research Organization (INRO; based in Vienna, Austria, founded in 1999) has coordinated a number of projects which focused on the treatment of patients with severe traumatic brain injury (TBI). An EU-funded project implemented TBI guidelines and evaluated the effects on outcomes in centres from Bosnia, Croatia and Macedonia [1]. An Austrian project analysed the epidemiology [2], treatment [3,4,5] and effects of guideline-based treatment of patients with severe TBI [6]. A database developed by the INRO was used to collect the data for these projects; today, this database has data on 1,172 patients with severe TBI. As all these projects were purely observational, this database includes data on paediatric as well as geriatric patients, and on patients with low Glasgow Coma Scale (GCS) scores
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
