Early mortality predictor of severe traumatic brain injury: A single center study of prognostic variables based on admission characteristics

Abstract

Objective

Traumatic brain injury (TBI) is one of the leading cause of death in many developing countries. The intention of this study was to develop a predictor model – to identify high death risk of severely head-injured patients in an early period in order to plan an effective and efficient treatment strategy.

Method

We conducted a retrospective cross-sectional study with subjects of severe TBI patients (n = 61) from 1st of January to 31st December 2010. Variables included age, gender, blood pressure, mean arterial pressure, pulse rate, respiration rate, temperature, Glasgow Coma Scale (GCS) score, motor response, choice of treatment and head computed tomography (CT) profiles. These models – then analyzed using multiple logistic regression.

Results

The outcome of this study produced five factors that correlated significantly with the survival of these patients: compression in basal cistern, low motor response (<4), presence of intradural lesion, mean arterial pressure, and midline shift. We divided these factors into major and minor factor according to their contribution to survival. Compression of basal cistern compression and low motor response (<4) are the most significant factors in predicting mortality (sensitivity greater than 90%).

Conclusion

Basal cistern compression and motor response were the most valuable factors in determining the risk of death in severe TBI patients.

Keywords

Traumatic brain injury - Prognosis - Early mortality

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