Abstract

Introduction: Traumatic brain injury (TBI) is a major cause of death and disability throughout the world. Injuries, including TBI, are projected to account for 20% of the worldwide burden of death and disability by 2020. Reliable assessment of prognostic factors in patients with traumatic brain injury (TBI) may guide the treatment strategy and allocation of resources

Objective: This is a prospective observational study of factors predicting clinical outcomes in traumatic brain injury patients.

Methods: One hundred patients with traumatic brain injuries and GCS more than 3 admitted to neurosurgery department of South Valley University Hospital from January 2015 to January 2016 were enrolled in the study. Patients with major abdominal, cardiothoracic or orthopedic trauma, previous neurosurgical intervention or patients with psychiatric disorders were excluded from the study. General and neurological examination, history taking, laboratory investigations and plain CT brain were done for all patients. Patients underwent either conservative management or had neurosurgical intervention according to the type of brain injury. In this study, from multiple factors affecting TBI outcome, we studied sex, age, GCS, pupils reaction, comparison of pupil size in both eyes of the TBI patients. Assessment of all patients by clinical and radiological evaluation was done at discharge and after one month if needed.

Results: From 100 cases, there were 75 males and 25 females with variant age group ranging from few months to 81 years, more than two-thirds of them were suffering from TBI due to motor car accidents, 75% of patients were with mild to moderate head trauma and 25% were severe head trauma. From all cases 60% received medical treatment only, 16.7% from these conservative cases were with unfavorable outcome results, and 40% from all cases were in need to neurosurgical intervention, from these operative cases only 14.9% were with unfavorable outcomes. Collectively 84% of cases were with favorable outcome results, and we found the most important factors that favor outcome were higher admitting GCS, equal reactive pupils, children age group ( increasing age was associated with worse outcome results ).