Influence of severity of traumatic brain injury at hospital admission on clinical outcomes

Abstract

Traumatic brain injury (TBI) is a public health problem with high mortality and socioeconomic repercussions. We aimed to investigate the influence of TBI severity on the length of mechanical ventilation (MV) stay and length of hospital stay and on the prevalence of tracheostomy, pneumonia, neurosurgery and death. This retrospective, observational study evaluated medical records of 67 patients with TBI admitted to Irmandade da Santa Casa de Misericórdia de São Paulo. Severity was determined according to the Glasgow Coma Scale (GCS): mild (13-15 points; 36 patients; 53.7%), moderate (9-12 points; 14 patients; 20.9%) or severe (3-8 points; 17 patients; 25.4%). Severe TBI patients had higher prevalence of tracheostomy, pneumonia and neurosurgery. No significant differences were observed between TBI severity, mortality and length of MV stay. However, TBI severity influenced the length of hospital stay. TBI severity at admission, evaluated according to the GCS, influenced the prevalence of tracheostomy, pneumonia, neurosurgery and was associated to prolonged hospital stay.

Factors associated with aspiration pneumonia and preventive measures in hospitalized elderly: a systematic review of observational studies

“…Another study related the old age to the fact that these patients had their physiological functions impaired 19 . Elderly people undergo anatomical and physiological changes related to the natural process of aging, impairing swallowing, increasing the risk of aspiration pneumonia 19,20 .…”

Correlação entre o tempo para a primeira sedestação beira leito e o tempo de internação hospitalar em vítimas de traumatismo cranioencefálico

“…Ao analisar-se o tempo de TOT, notou-se a média de 7,71 ± 3,48 dias, inferior ao tempo de VM que foi de 8 (5-12) dias. Quanto ao tempo para decanulaçao, apresentou-se a mediana de 19 (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)5). Já em relação ao tempo para realização da primeira sedestação beira leito, bipedestação e deambulação, teve como mediana, respectivamente, 6 (4-9), 7 (5-11,75) e 7,5 (5)(6)(7)(8)(9)(10)(11).…”

“…No estudo de Silva TH, et al (2018), mostra as repercussões da gravidade do TCE verificado na admissão hospitalar sobre os resultados clínicos, onde teve uma amostra 67 indivíduos, constatou que 53,7% teve TCE leve e apenas 25,4% TCE grave, divergindo do estudo atual. Mas em relação ao tratamento adotado frente a estes pacientes, nota-se dados semelhante, pois 76,1% foram submetidos ao tratamento conservador e 23,9% ao tratamento cirúrgico.…”

Preliminary study for Neurovisual Assessment Model using Eye Tracking (NAMET) related to cognitive functions for TBI patients

“…Treatment for visual dysfunctions can improve Reading Problems; oculomotor dysfunctions, balance and binocular disorders using prisms, lenses and filters for both attention and concentration difficulties. 18,[29][30][31][32][33] Literature shows cases of improvement post-TBI visual symptoms using nonfunctional lenses, prisms, filters, binasal occlusions, cases of improvement of depressive symptoms, aggressive behavior, self-confidence, self-esteem, posture and balance. 4,13,31,32,[34][35][36]…”