Outcome in patients with head injury: Do extra-cranial injuries worsen prognosis?

  • Varun Dua Maharishi Markandeshwar Institute of Medical Sciences and Research (MMIMSR), Mullana, Ambala, Haryana 133207 (India)
  • Nitin Ahuja Department of Anaesthesia and Intensive Care, PGIMER, Chandigarh (India)
  • Hemant Bhagat Department of Anaesthesia and Intensive Care, PGIMER, Chandigarh (India)
  • Tanvir Samra Department of Anaesthesia and Intensive Care, PGIMER, Chandigarh (India)
  • Venkata Ganesh Department of Anaesthesia and Intensive Care, PGIMER, Chandigarh (India)
  • Saravdeep Dhatt Department of Orthopedics, PGIMER, Chandigarh (India)
  • Pravin Salunke Department of Neurosurgery, PGIMER, Chandigarh (India)
Keywords: Head injury, Multiple injuries, Polytrauma, Outcome, Secondary insults

Abstract

Introduction: Patient age and severity of brain injury are validated prognostic indicators in patients with polytrauma. This prospective observational study was conducted to study the influence of extracranial injuries on neurological outcome of patients with traumatic brain injury (TBI).

Methodology: Patients with TBI aged 20-60 years were enrolled and categorized into two groups: Group 1- with extracranial injuries; Group 2- without extracranial injuries. Patients with fixed and dilated pupils, brainstem injuries, delay of more than 24 hours for hospitalization, and patients who developed secondary insults were excluded.

Results: Complete follow up and data collection was feasible in 33 patients of Group 1 and in 47 patients of Group 2. Severity of head injury, SOFA score, co-morbid conditions, duration of hospital stay, mortality, GCS scores on admission and Δ GCS (GCS on admission – GCS at time of discharge) were comparable between the two groups. The duration of mechanical ventilation and the ISS scores were significantly higher in patients with extracranial injuries. Extracranial injuries did not influence the survival rate. Severity of head injury was the prime determinant of survival. Extracranial injuries were shown to have a synergistic effect on morbidity.

 

Published
01-21-2019
How to Cite
Dua, V., Ahuja, N., Bhagat, H., Samra, T., Ganesh, V., Dhatt, S., & Salunke, P. (2019). Outcome in patients with head injury: Do extra-cranial injuries worsen prognosis?. Anaesthesia, Pain & Intensive Care, 411-416. Retrieved from https://apicareonline.com/index.php/APIC/article/view/183
Section
Original Articles