Determinants of mortality in patients with traumatic brain injury

BACKGROUND
We aimed to determine factors associated with mortality rates in patients with traumatic brain injury (TBI).
METHODS
Registered data of a national trauma project conducted in eight major cities in Iran during a five-year period were used. Patients with a TBI were identified and both univariate and multivariate analyses were performed.
RESULTS
2274 brain-injured patients including 1794 males (78.9%) were identified. The mean age of the patients was 30.1 ± 19.11 years. The age of 345 patients was less than 12, while 137 patients were older than 65. 383 patients (16.9%) died as a result of their injury. Univariate analysis showed a significant association between mortality and the following factors: age, sex, Glasgow Coma Scale (GCS), Injury Severity Score (ISS), systolic, diastolic and mean arterial blood pressure (BP), and respiratory rate (RR) (p<0.05). The logistic regression analysis revealed a statistically significant association between death and age (odds ratio [OR]=1.04), GCS (OR=0.59), ISS (OR=1.03), mean arterial BP (OR=0.71), and RR (OR=0.82) one-half hour after hospital arrival.
CONCLUSION
Our results demonstrated that age, GCS, ISS, BP, and RR as prognostic factors in patients with TBI indicate those that need special care during the initial management in the emergency department.

Travmatik beyin hasarý olan hastalarda mortalite belirleyicileri

AMAÇ
Travmatik beyin hasarý (TBH) bulunan hastalarda mortalite ile iliþkili faktörleri belirlemeyi amaçladýk.
GEREÇ VE YÖNTEM
Ýran’da beþ yýllýk bir periyot boyunca 8 büyük kentte yürütülen ulusal travma projesinin veri kayýtlarý kullanýldý. TBH’li hastalar belirlendi, tek deðiþkenli ve çok deðiþkenli analizler yapýldý.
BULGULAR
Beyin yaralanmasý geçirmiþ 2274 hasta kaydýna ulaþýldý (1794 erkek, 480 kadýn). Hastalarýn ortalama yaþý 30,1±19,11 yýl idi, 345 hastanýn yaþý 12’den küçük, 137 hastanýn yaþý 65’den büyüktü. Hastalarýn 383’ü (%16,9) bir yaralanmaya baðlý ölmüþtü. Tek deðiþkenli analiz; mortalite ile þu faktörler arasýnda anlamlý bir birliktelik bulunduðunu gösterdi: Yaþ, cinsiyet, Glasgow koma skoru (GKS), yaralanma ciddiyeti skoru (YCS), sistolik, diyastolik ve ortalama arteriyel kan basýncý (KB) ve solunum oraný (SO) (p<0,05). Lojistik regresyon analizi, hastaneye varýþtan yarým saat sonrasýndan itibaren ölüm ile aþaðýdakiler arasýnda anlamlý bir iliþki bulunduðunu gösterdi: Yaþ (OR=1,04), GKS (OR=0,59), YCS (OR=1,03), ortalama arteriyel KB (OR=0,71) ve SO (OR=0,82).
SONUÇ
Bizim sonuçlarýmýz, acil servis bölümünün ilk tedavisi süresince özel bakým gerektiren TBH’li hastalarda prognostik faktörlerin yaþ, GKÖ, YCS, KB ve SO olduðunu göstermiþtir.