Indicators of prognosis in severe traumatic brain injury

摘要

This study is based on the retrospective analysis of 123 children with severe combined and isolated brain-trauma injury who were admitted to the Clinical and Research Institute of Emergency Children's Surgery and Trauma during 2004-2011. Combined trauma was in 64%. 17% had 3-4 GCS scores; 39% had 5-6 scores and 44% had 7-8 scores. Severity of combined injuries was assessed by ISS . Outcomes were assessed using the Extended GOS. Mortality was in 28,4%; vegetative state- in 3%; severe disability- in 24,2%; good recovery- in 42%. Using techniques of mathematical statistical analysis it has been found out that the outcome is determined by level of GCS, eye pupil state and reaction, degree of intracranial damage at CT examination, intracranial hypertension (ICP >30). Severity of combined trauma has a significant effect if brain trauma has 6- 8 GCS scores. A search for correlating clinical, biochemical and X-ray findings can considerably increase the quality of prognosis and is a subject for further investigations.