Predictive factors in the prognosis of victims of trauma crisis in brain

Abstract

Background: Among mechanical traumas, traumatic brain injury (TBI) is the main determinant of deaths and sequelae in polytrauma patients. TBI is defined as any traumatic injury to the brain that results in anatomical injury such as skull fracture or scalp injury, functional impairment of the meninges, brain and its vessels or momentary or permanent brain changes, of a cognitive or physical nature. Objective: The present work aims to conduct a literature review on the factors that are predictive in the prognosis of victims of traumatic brain injury. Methods: This is a literature review based on the medical literature and scientific articles indexed in the Scientific Eletronic Library Online (SCIELO) and VHL-Brazil. Results: Several factors are related to a worse prognosis in patients suffering from TBI, and the most cited are: score equal to or less than 8 on the Glasgow Coma Scale (ECG) on admission; age over 60 years; tomographic changes showing diffuse axonal lesion or cerebral edema; pupils with abolished photomotor reflexes; arterial hypotension at admission; hyperthermia and male sex. Studies address that the initial clinical-neurological severity, measured by ECG, has the greatest significant influence on the evolution of patients, showing that the initial clinical manifestation points out the severity of primary and secondary injuries associated with TBI. As well as ECG, several other factors such as the brain’s susceptibility to injury, the extent and severity of the injuries, the presence of global or focal injuries, associated injuries and the initial response to treatment are also cited as useful in determining the evolution of cases of victims of TCE. Conclusions: It was found that the TBI is the main responsible for high lethality rates in polytrauma patients worldwide and from obtaining these data in recent years, studies have been deepened in order to search for the prognostic factors for TBI. The identification of these indicators has represented a major advance in the search for alternatives to guide the treatment of the patient and estimate the final result.