Predicting outcome in traumatic brain injury: Sharing experience of pilot traumatic brain injury registry

Roads are considered a sign of development bringing colossal benefits to community as socioeconomic and logistic facilitator. Yet, growth of road network has brought road crashes leading to civic pain from premature deaths of productive age group. In 2017, 16 citizens were killed and 53 injured every hour on Indian roads as per officially reported data, while a fair number go unreported. This is unacceptably high when compared with international standards. Risk correlates of road traffic injuries (RTIs) need to be redefined so as to form a continuum with other confounding factors that impact to take lives on road. Risk factors impacting RTIs vary from human components to the roles and responsibilities of healthcare stakeholders. We should have made roads safer for all citizens because a large percentage of population – children, pedestrians, cyclists, motorcyclists, and the elderly – are most vulnerable. A taskforce was set up by the Academy of Family Physicians of India to scientifically analyze the literature available to assess risks and put forward appropriate recommendations.

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“…They lead to many cases of TBI following RTIs with reported complications of cognitive dysfunctions. [48495051525354]…”

Section: Risk Factors For Road Traffic Accidentsmentioning

confidence: 99%

Public health crisis of road traffic accidents in India: Risk factor assessment and recommendations on prevention on the behalf of the Academy of Family Physicians of India

Pal

Ghosh

Kumar

et al. 2019

J Family Med Prim Care

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“…Depending on the neurological examination and findings on CT scan of brain, the need of surgery is decided for acute TBI. [ 6 - 8 ] The patients who do not require neurosurgical procedures initially are subjected to close observation under intensivists and neurosurgeons. Patients who do not improve with medical management or deteriorate clinically are routinely subjected to repeat CT scan and laboratory investigations to determine the cause of neurological deterioration.…”

Section: Introductionmentioning

confidence: 99%

Risk factors of deterioration in patients of head injury with non-operative management on first neurosurgical consultation

Churiwala

Garale

Kawale

et al. 2022

JNRP

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Objectives: In most of the emergency trauma intensive care units (ICUs) of India, neurosurgical opinion is sought for patients presenting with head trauma after earliest possible resuscitation to determine the further line of management. This study aimed to identify common risk factors, leading to neurological deterioration in conservatively managed patients of traumatic brain injury (TBI). Materials and Methods: This retrospective study analyzed patients admitted with acute TBI and traumatic intracranial hematoma under emergency trauma care ICU who did not require neurosurgical operation within 48 h of trauma. The recorded data were analyzed to determine the predictors of neurological deterioration using univariate and binary logistic regression analysis in SPSS-16 software. Results: Medical records of consecutive 275 patients of acute TBI presenting to the emergency department were studied. One hundred and ninety-three patients were afflicted with mild TBI (70.18%), 49 patients had moderate TBI (17.81%), and 33 had severe TBI (12%). In the outcome, 74.54% of patients were discharged, and operative decision was made on 6.18% of patients and 19.27% died. Severe TBI is the independent predictor of neurological deterioration during their stay in ICU. Progressive hemorrhagic injury (PHI) showed neurological deterioration in 86.5% of patients. Systemic inflammatory response syndrome (SIRS) was present in 93.5% of patients who had deteriorated neurologically. Dyselectrolytemia was the biochemical derangements seen in 24.36% of cases. Conclusion: This study revealed severe TBI, PHI, and SIRS to be strong and independent risk factors of neurological deterioration.

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“…These demanding painful soul-searching ultimately give birth to protocol-based outcomes of victims of TBI. [ 11 12 13 14 15 ]…”

Section: Introductionmentioning

confidence: 99%

Morbidity audit of 704 traumatic brain injury cases in a dedicated South Indian trauma center

et al. 2018

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Background: In the era of evidence-based health care, protocol of intervention in traumatic brain injury (TBI) cases help decide more easily and safely about patients and prevent unnecessary transfer of patients to other centers. Objectives: The objective of this study is to provide protocol-based intervention and evaluate the epidemiological, clinical characteristics of TBI cases. Methods: This prospective study was conducted on 704 patients who were suspected of TBI at the Department of Neurosurgery, Narayana Medical College and Hospital, followed by protocol-based intervention assessed and reassessed repeatedly. Results: Overall, TBI involved 569 (80.82%) adults in the productive age groups (21–60 years); among males 81.47%. Among males, highest (23.15%) cases were in the age group of 31–40 years while in females, majority (27.04%) was among 41–50 years. Road traffic accidents were the most common (54.12%) mechanism of injury followed by fall (21.31%) and two-wheelers (15.20%). More than half sustained mild TBI (51.42%) while 26.28% moderate TBI and 22.30% severe TBI; among males, severe TBI victims 102 (18.82%) were in the productive age group. Loss of consciousness was almost a universal and significant observation (95.45%); vomiting was next common finding (76.42%). Bleeding from the ear-nose-throat (ENT) region was more in males (33.58%) than females (20.75%). Glasgow coma scale was significantly related with loss of consciousness (91.08%), vomiting (63.06%), and ENT bleeding (44.59%) in severe, moderate, and mild injuries. Conclusion: A rational clinical acumen with judicious use of diagnostic protocol leads to better management of TBI without unnecessary imaging and thus reduce total health-care costs.

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Predicting outcome in traumatic brain injury: Sharing experience of pilot traumatic brain injury registry

Cited by 11 publications

References 31 publications

Public health crisis of road traffic accidents in India: Risk factor assessment and recommendations on prevention on the behalf of the Academy of Family Physicians of India

Public health crisis of road traffic accidents in India: Risk factor assessment and recommendations on prevention on the behalf of the Academy of Family Physicians of India

Risk factors of deterioration in patients of head injury with non-operative management on first neurosurgical consultation

Morbidity audit of 704 traumatic brain injury cases in a dedicated South Indian trauma center

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