REVIEW PAPER
Prognostic factors in traumatic brain injury and their association with outcome
 
More details
Hide details
1
Department of Trauma Surgery and Emergency Medicine, Medical University of Lublin, Poland
 
2
Department of Internal Medicine, Medical University of Lublin, Poland
 
 
Corresponding author
Andrzej Prystupa   

Department of Internal Medicine, Medical University of Lublin
 
 
J Pre Clin Clin Res. 2015;9(2):163-166
 
KEYWORDS
ABSTRACT
Introduction:
Traumatic brain injuries (TBI) are a real social problem, with an upward trend worldwide. TBI is the leading cause of death and disability, especially among young men. Each year in Europe, and also in Poland, 243 per 100,000 individuals suffer from TBI. Assessing prognosis after traumatic brain injury is very important in order to help clinicians to make a decision about the implementation of specific methods of treatment, and to make communication with the patient and the patient’s family easier.

Objective:
The objective of this review was to present prognostic factors, to assess outcomes within a short time after a moderate to severe traumatic brain injury, as well as to predict functional outcome. The most important independent variables were: age, Glasgow Coma Scale (GCS) motor score, pupil response, Marshall CT classification and traumatic subarachnoid haemorrhage. Other important prognostic factors included hypotension, hypoxia, glucose, coagulopathy, haemoglobin and category of CT characteristic, such as midline shift, mass lesion, basal cistern.

Conclusions:
.Gender and intraventricular haemorrhage did not have predictive value. This subject needs much more research in the area of new prognostic factors which would be better associated with outcome after traumatic brain injury.

 
REFERENCES (36)
1.
Pilśniak J, Ślusarz R. Epidemiologia urazów czaszkowo-mózgowych w materiale własnym Pogotowia Ratunkowego w Rypinie: Badania retrospektywne. Pielęgniarstwo Neurologiczne i Neurochirurgiczne 2013; 2(1): 4–8 (in Polish).
 
2.
Salim A, Ley EJ, Cryer HG, Margulies DR, Ramicone E, Tillou A. Positive serum ethanol level and mortality in moderate to severe traumatic brain injury. Arch Surg. 2009; 144(9): 865–871.
 
3.
Tagliaferri F, Compagnone C, Korsic M, Servadei F, Kraus J. A systematic review of brain injury epidemiology in Europe. Acta Neurochir. 2006; 148(3): 255–268.
 
4.
Thurman DJ, Alverson C, Dunn KA, Guerrero J, Sniezek JE. Traumatic brain injury in the United States: A public health perspective. J Head Trauma Rehabil. 1999; 14(6): 602–615.
 
5.
Hukkelhoven CW, Steyerberg EW, Habbema JD, Farace E, Marmarou A, Murray GD, et al.. Predicting Outcome after Traumatic Brain Injury: Development and International Validation of Prognostic Scores Based on Admission Characteristics. J Neurotrauma. 2005; 22(10): 1025–1039.
 
6.
MRC CRASH Trial Collaborators, Perel P, Arango M, Clayton T, Edwards P, Komolafe E, at al. Predicting outcome after traumatic brain injury: practical prognostic models based on large cohort of international patients. BMJ. 2008; 336(7641): 425–429.
 
7.
Husson EC, Ribbers GM, Willemse-van Son AH, Verhagen AP, Stam HJ. Prognosis of six-month functioning after moderate to severe traumatic brain injury: a systematic review of prospective cohort studies. J Rehabil Med. 2010; 42(5): 425–436.
 
8.
Murray GD, Butcher I, McHugh GS, Lu J, Mushkudiani NA, Maas AI, et al. Multivariable prognostic analysis in traumatic brain injury: results from the IMPACT study. J Neurotrauma 2007; 24(2): 329–337.
 
9.
Mushkudiani NA, Engel DC, Steyerberg EW, Butcher I, Lu J, Marmarou A, et al. Prognostic value of demographic characteristics in traumatic brain injury: results from the IMPACT study. J Neurotrauma 2007; 24(2): 259–269.
 
10.
Fabbri A, Servadei F, Marchesini G, Stein SC, Vandelli A. Early predictors of unfavourable outcome in subjects with moderate head injury in the emergency department. J Neurol Neurosurg Psychiatr. 2008; 79(5): 567–573.
 
11.
Shutter L, Tong KA, Holshouser BA. Proton MRS in acute traumatic brain injury: role for glutamate/glutamine and choline for outcome prediction. J Neurotrauma. 2004; 21(12): 1693–1705.
 
12.
Groswasser Z, Cohen M, Keren O. Female TBI patients recover better than males. Brain Inj. 1998; 12(9): 805–808.
 
13.
Ponsford JL, Myles PS, Cooper DJ, Mcdermott FT, Murray LJ, Laidlaw J, et al. Gender differences in outcome in patients with hypotension and severe traumatic brain injury. Injury. 2008; 39(1): 67–76.
 
14.
Moppett IK. Traumatic brain injury: assessment, resuscitation and early management. Br J Anaesth. 2007; 99(1): 18–31.
 
15.
Hebb MO, McArthur DL, Alger J, Etchepare M, Glenn TC, Bergsneider M, et al. Impaired percent alpha variability on continuous electroencephalography is associated with thalamic injury and predicts poor long-term outcome after human traumatic brain injury. J Neurotrauma 2007; 24(4): 579–590.
 
16.
Hukkelhoven CW, Steyerberg EW, Rampen AJ, Farace E, Habbema JD, Marshall LF, et al. Patient age and outcome following severe traumatic brain injury: an analysis of 5600 patients. J Neurosurg. 2003; 99(4): 666–73.
 
17.
Saadat S, Akbari H, Khorramirouz R, Mofid R, Rahimi-Movaghar V. Determinants of mortality in patients with traumatic brain injury. Ulus Travma Acil Cerrahi Derg. 2012; 18(3): 219–224.
 
18.
Wang JY, Bakhadirov K, Devous MD Sr, Abdi H, McColl R, Moore C, et al. Diffusion tensor tractography of traumatic diffuse axonal injury. Arch Neurol. 2008; 65(5): 619–626.
 
19.
Marmarou A, Lu J, Butcher I, McHugh GS, Murray GD, Steyerberg EW, et al. Prognostic value of the Glasgow Coma Scale and pupil reactivity in traumatic brain injury assessed pre-hospital and on enrollment: an IMPACT analysis. J Neurotrauma. 2007; 24(2): 270–280.
 
20.
Fabbri A, Servadei F, Marchesini G, Stein SC, Vandelli A. Early predictors of unfavourable outcome in subjects with moderate head injury in the emergency department. J Neurol Neurosurg Psychiatr 2008; 79(5): 567–573.
 
21.
Maas AI, Steyerberg EW, Butcher I, Dammers R, Lu J, Marmarou A, et al. Prognostic Value of Computerized Tomography Scan Characteristics in Traumatic Brain Injury: Results from the IMPACT Study. J Neurotrauma. 2007; 24(2): 303–314.
 
22.
Hiler M, Czosnyka M, Hutchinson P, Balestreri M, Smielewski P, Matta B, et al. Predictive value of initial computerized tomography scan, intracranial pressure, and state of autoregulation in patients with traumatic brain injury. J Neurosurg. 2006; 104(5): 731–737.
 
23.
Pillai SV, Kolluri VR, Praharaj SS. Outcome prediction model for severe diffuse brain injuries: development and evaluation. Neurol India. 2003; 51(3): 345–349.
 
24.
Bahloul M, Chelly H, Ben Hmida M, Ben Hamida C, Ksibi H, Kallel H, et al. Prognosis of traumatic head injury in South Tunisia: a multivariate analysis of 437 cases. J Trauma. 2004; 57(2): 255–261.
 
25.
Servadei F, Nasi MT, Giuliani G, Cremonini AM, Cenni P, Zappi D, et al. CT prognostic factors in acute subdural haematomas: the value of the “worst” CT scan. Br J Neurosurg. 2000; 14(2): 110–116.
 
26.
Mattioli C, Beretta L, Gerevini S, Veglia F, Citerio G, Cormio M, et al. Traumatic subarachnoid hemorrhage on the computerized tomography scan obtained at admission: a multicenter assessment of the accuracy of diagnosis and the potential impact on patient outcome. J Neurosurg. 2003; 98(1): 37–42.
 
27.
Lannoo E, Van Rietvelde F, Colardyn F, Lemmerling M, Vandekerckhove T, Jannes C et al. Early predictors of mortality and morbidity after severe closed head injury. J Neurotrauma. 2000; 17(5): 403–414.
 
28.
Hendricks HT, Heeren AH, Vos PE. Dysautonomia after severe traumatic brain injury. Eur J Neurol. 2010; 17(9): 1172–1177.
 
29.
Rejeb I, Chakroun O, Chtara K, Boujelbene M, Ksibi H, Chaari A, et al. Factors predicting early outcome in patients admitted at emergency department with severe head trauma. J Acute Dis. 2015; 4(1): 68–72.
 
30.
McHugh GS, Engel DC, Butcher I, Steyerberg EW, Lu J, Mushkudiani N, et al. Prognostic value of secondary insults in traumatic brain injury: results from the IMPACT study. J Neurotrauma. 2007; 24(2): 287–293.
 
31.
Butcher I, Maas AI, Lu J, Marmarou A, Murray GD, Mushkudiani NA, et al. Prognostic value of admission blood pressure in traumatic brain injury: results from the IMPACT study. J Neurotrauma. 2007; 24(2): 294–302.
 
32.
Hukkelhoven CW, Steyerberg EW, Farace E, Habbema JD, Marshall LF, Maas AI. Regional differences in patient characteristics, case management, and outcomes in traumatic brain injury: experience from the tirilazad trials. J Neurosurg. 2002; 97(3): 549–557.
 
33.
Van Beek JG, Mushkudiani NA, Steyerberg EW, Butcher I, McHugh GS, Lu J, et al. Prognostic value of admission laboratory parameters in traumatic brain injury: results from the IMPACT study. J Neurotrauma. 2007; 24(2): 315–328.
 
34.
Joseph B, Aziz H, Zangbar B, Kulvatunyou N, Pandit V, O’Keeffe T, et al. Acquired coagulopathy of traumatic brain injury defined by routine laboratory tests: Which laboratory values matter?. J Trauma Acute Care Surg. 2014; 76(1): 121–125.
 
35.
Traumatic Brain Injury (TBI) Prognosis http://lifeinthefastlane.com/ ccc/traumatic-brain-injury-tbi-prognosis/.
 
36.
Steyerberg EW, Mushkudiani N, Perel P, Butcher I, Lu J, McHugh GS, et al. Predicting outcome after traumatic brain injury: development and international validation of prognostic scores based on admission characteristics. PLoS Med. 2008; 5(8): e165; discussion e165.
 
eISSN:1898-7516
ISSN:1898-2395
Journals System - logo
Scroll to top