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CC BY 4.0 · Indian Journal of Neurotrauma
DOI: 10.1055/s-0044-1795154
Original Article

Prognostic Factors of Recovery and Discharge Outcome in Adults after Moderate Traumatic Brain Injury

Hossam Elnoamany
1   Neurosurgery Department of Menoufia University, Shibin Elkom, Egypt
,
Yasser Bahgat El Sisi
1   Neurosurgery Department of Menoufia University, Shibin Elkom, Egypt
,
Abdulla Mostafa Abdulla Abu Elsoud
1   Neurosurgery Department of Menoufia University, Shibin Elkom, Egypt
,
Ayman Ahmed Omar
2   General Surgery Department of Menoufia University, Shibin Elkom, Egypt
,
Hany Elkholy 
1   Neurosurgery Department of Menoufia University, Shibin Elkom, Egypt
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Abstract

Background Traumatic brain injury (TBI) is a leading cause of mortality and morbidity particularly among young people. Identification of prognostic factors can be considerably helpful for clinical decision-making and prediction of outcome.

Objective The aim of this study was to identify prognostic factors supposed to be of value in predicting functional outcome in moderate TBI patients.

Materials and Methods This was a prospective case series study conducted from March 2023 to January 2024 involving 72 TBI patients with a Glasgow Coma Scale (GCS) score of 9 to 13. Demographic, clinical, laboratory, and management data were collected, analyzed, and correlated with patient outcomes. Based on the Extended Glasgow Outcome Scale (GOSE), patients were assigned to have either favorable outcome (GOSE score: 5–8) or poor outcome (GOSE score: 1–4).

Results The mean age was 38.76 ± 18.30 years. The mean GCS score on admission was 11.68 ± 1.27. Surgical intervention was indicated in 29 patients (40.3%). The average length of hospital stay was 9.01 ± 7.88 days. Sixty-five patients (90.3%) had a favorable outcome and 7 patients (9.7%) had a poor outcome. Prognostic factors with significant impact on outcome included the GCS score on admission (p = 0.002); pupillary responses (p = 0.011); blood pressure (p = 0.005); acute subdural hematoma (ASDH) as a primary lesion (p = 0.049); and time to admission, comorbidities, blood glucose, hemoglobin%, oxygen saturation, coagulation profile, endotracheal intubation, and tracheostomy (p < 0.001).

Conclusion In moderate TBI patients, delayed hospital arrival, low GCS score, unequal pupils, pretrauma comorbidities, hypotension, hypoxia, anemia, endotracheal intubation, tracheostomy, and ASDH were associated with unfavorable functional recovery and could be considered as poor prognostic factors.

Keywords

functional recovery - head trauma - moderate traumatic brain injury - outcome - prognostic factors

Note

This study was performed in the Department of Neurosurgery, Faculty of Medicine, Menoufia University Hospital, Egypt.


Authors' Contributions

All the authors made a significant contribution to the work reported, whether that was in the conception; study design; execution; and acquisition, analysis, and interpretation of data. All the authors took part in drafting, revising, and final approval of the article. This article has been read and approved by all the authors and all the authors agreed to be accountable for all aspects of the work.


Ethical Approval

This study was approved by the clinical research committee of the Faculty of Medicine, Menoufia University (IRB approval number: 3/2023.SURG.37) and it followed the tenets of the Declaration of Helsinki.




Publication History

Article published online:
25 November 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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