Factors Affecting Surgical Outcome of Traumatic Brain Injury Patients
Keywords:
Favorable outcome, Unfavorable outcome, Traumatic Brain injury (TBI), Midline shiftAbstract
Traumatic brain injury (TBI) is the common cause of brain damage, resulting in death or long term-disability. Aim of this study was to identify factors affecting surgical outcome of traumatic brain injury patients. Eighty four patients was diagnosed with traumatic brain injury and was operated at Phra Nakhon Si Ayutthaya hospital from 1 June 2012-29 February 2015 and followed up for 6 months.
The results of study showed median age of patient was 34.5 years (4-77). Male:Female ratio was 6:1. Median Glasgow Coma Score (GCS) at admission was 9.0 (3-15). Good pupil reactivity was 50 case (59.5%). Median time from arrival hospital to operation was 4.0 hours (0.75-115). CT brain showed Acute subdural hematoma 24 cases (28.6%), Epidural hematoma 24 cases (28.6%), Multiple hemorrhage 31 cases (36.9%), Depress skull fracture 5 cases (6%). Mean midline shift was 0.79 cm. (0-1.8). The operation was Craniotomy 28 cases (33.3%) and Craniectomy 45 cases (53.6%). In-hospital mortality rate was 28.6%. Surgical outcome was evaluated at 6 months, dividing to favorable outcome (GOS4-5) and unfavorable outcome (GOS1-3). Patients with midline shift 5 mm. had significantly more favorable outcome (85.2% vs 40.4%) compared with those with midline shift >5 mm.
Conclusion: Midline shift 5 mm. is only factor that affecting favorable surgical outcome of Traumatic brain injury patients
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