What are the strongest indicators of intracerebral hemorrhage in mild traumatic brain injury?
| Autor: | Thanakorn Wannakul, Parichat Tanmit, Phati Angkasith, Supatcha Prasertcharoensuk, Kittisak Sawanyawisuth, Warinthorn Phuttharak, Wattana Sukeepaisarnjaroen, Chaiyut Thanapaisal, Panu Teeratakulpisarn, Amnat Kitkhuandee, Narongchai Wongkonkitsin |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
RD1-811 Traumatic brain injury Critical Care and Intensive Care Medicine Epidural hematoma Medicine Original Research Intracerebral hemorrhage Base of skull business.industry RC86-88.9 Head injury Glasgow Coma Scale Medical emergencies. Critical care. Intensive care. First aid Stepwise regression medicine.disease intracerebral hemorrhage nervous system diseases Skull medicine.anatomical_structure Surgery Radiology epidural hematoma business head injury subdural hematoma |
| Zdroj: | Trauma Surgery & Acute Care Open, Vol 6, Iss 1 (2021) Trauma Surgery & Acute Care Open |
| ISSN: | 2397-5776 |
| Popis: | BackgroundAlthough there are eight factors known to indicate a high risk of intracranial hemorrhage (ICH) in mild traumatic brain injury (TBI), identification of the strongest of these factors may optimize the utility of brain CT in clinical practice. This study aimed to evaluate the predictors of ICH based on baseline characteristics/mode of injury, indications for brain CT, and a combination of both to determine the strongest indicator.MethodsThis was a descriptive, retrospective, analytical study. The inclusion criteria were diagnosis of mild TBI, high risk of ICH, and having undergone a CT scan of the brain. The outcome of the study was any type of ICH. Stepwise logistic regression analysis was used to find the strongest predictors according to three models: (1) injury pattern and baseline characteristics, (2) indications for CT scan of the brain, and (3) a combination of models 1 and 2.ResultsThere were 100 patients determined to be at risk of ICH based on indications for CT of the brain in patients with acute head injury. Of these, 24 (24.00%) had ICH. Model 1 found that injury due to motor vehicle crash was a significant predictor of ICH, with an adjusted OR (95% CI) of 11.53 (3.05 to 43.58). Models 2 and 3 showed Glasgow Coma Scale (GCS) score of 13 to 14 after 2 hours of observation and open skull or base of skull fracture to be independent predictors, with adjusted OR (95% CI) of 11.77 (1.32 to 104.96) and 5.88 (1.08 to 31.99) according to model 2.DiscussionOpen skull or base of skull fracture and GCS score of 13 to 14 after 2 hours of observation were the two strongest predictors of ICH in mild TBI.Level of evidenceIII. |
| Databáze: | OpenAIRE |
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