Outcome prediction in early management of severe head injury: An experience in Malaysia

Abstract

The outcome of 109 patients with severe head injury was studied in relation to clinical and computed tomographic (CT) criteria on admission, after resuscitation. Age, Glasgow Coma Score (GCS) and state of pupils strongly correlated with outcome. The presence of hypothalamic disturbances, hypoxia and hypotension were associated with an adverse outcome. The CT indicators associated with poor outcome were perimesencephalic cistern (PMC) obliteration, subarachnoid haemorrhage, diffuse axonal injury and acute subdural haematoma. The prognostic value of midline shift and mass effect were influenced by concomitant presence of diffuse brain injury. For the subset of patients aged < 20 years, with GCS 6-8 and patent PMC (n = 21), 71.4% correct predictions were made for a good outcome. For the subset of patients aged > 20 years, with GCS 3-5 and partial or complete obliteration of PMC (n = 28), 89.3% correct predictions were made for a poor outcome.

Prevalence of persistent vegetative state in patients with severe traumatic brain injury and its trend during the past four decades: A meta-analysis

“…No study has reported the prevalence in Africa. Only 2 of the 21 studies were from developing countries (7.33% from Kelantan, Malaysia and 0.68% from Rosario, Argentina) (Petroni et al, 2010;Selladurai et al, 1992) The overall prevalence in developing countries is 6.3%, which is higher than the overall prevalence of 2.8% in developed countries. The quality and availability of emergency and intensive care services differs among different regions.…”

“…After 2324 duplications removed, 1930 additional articles were excluded on the basis of their titles or abstracts, resulting in the full text of 341 articles being examined. Finally, 20 articles reporting 21 cohort studies were included in the present analysis (Andriessen et al, 2011;Fearnside, Cook, McDougall, & McNeil, 1993;Foulkes, Eisenberg, Jane, Marmarou, & Marshall, 1991;Gomez et al, 2000;Heiden, Small, Caton, Weiss, & Kurze, 1983;Jourdan et al, 2013;Judson, Cant, & Shaw, 1990;Lannoo et al, 2000;Mamelak, Pitts, & Damron, 1996;; L. S. Myburgh et al, 2008;Nordstrom, Messeter, Sundbarg, & Wahlander, 1989;Pang et al, 2007;Petroni et al, 2010;Rusnak, Janciak, Majdan, Wilbacher, & Mauritz, 2007;Selladurai, Jayakumar, Tan, & Low, 1992;Stranjalis et al, 2008;Turazzi, Bricolo, & Pasut, 1984;Turazzi, Bricolo, Pasut, & Formenton, 1987). A flow diagram of the selection process is presented in Fig.…”

“…The highest prevalence was in Kelantan, Malaysia (Selladurai et al, 1992). The study period was 1989-1991.…”

“…The included studies were mostly from America and Europe; of 21 studies, 11 were from Europe, 3 from the United States, and 1 was carried out in both. Only two studies were from Asia (7.33% from Kelantan, Malaysia and 6.60% from Singapore) (Pang et al, 2007;Selladurai et al, 1992) and one from Latin America (0.68% from Rosario, Argentina) (Petroni et al, 2010). No study has reported the prevalence in Africa.…”

Traumatismo cranioencefálico: correlação entre dados demográficos, escala de Glasgow e tomografia computadorizada de crânio com a mortalidade em curto prazo na cidade de Maceió, Alagoas

“…Vários estudos têm examinado a associação entre a TC de crânio, a gravidade da lesão e o prognóstico (Gennarelli et al, 1982;Greene et al, 1995;Kido et al, 1992;Wardlaw et al, 2002 (Gennarelli et al, 1982;Eisenberg et al, 1990;Selladurai et al, 1992;Kakarieka et al, 1994;Greene et al, 1995;Greene et al, 1996;Chesnut et al, 2000;Ono et al, 2001;Servadei et al, 2002 (Annegers et al, 1980); em San Diego as maiores taxas foram constatadas na faixa etária de 16 a 25 anos (Kraus et al, 1984) e no Bronx, o pico de incidência foi verificado na faixa etária de 16 a 30 anos (Cooper et al, 1983 ( Durkin et al, 1998). No entanto, em um estudo científico realizado em Minnesota entre 1965 a 1972, incluindo todos os casos de TCE, de todas as faixas etárias, foi detectado que 15% dos casos encontrava-se na faixa etária de 0 a 1 ano, 17% na de 2 a 10 anos e 26% na faixa etária de 11 a 20 anos (Annegers et al, 1980 (Jager et al, 2000) e de 1,5:1 no período de 1995 a 1996 (Guerrero et al, 2000).…”