Correlation between the Profile of Intracranial Hemorrhages Resulting from Traumatic Brain Injury and the Glasgow Outcome Scale (GOS) at Discharge

Authors

  • Luiz Eduardo Kostin Felipe de Natividade Medical Interns at Pontifical Catholic University of Paraná, Brazil Author
  • Carlos Alberto Mattozo Professor of Neurosurgery at Pontifical Catholic University of Paraná, Senior Researcher, Brazil Author
  • Ildo Valter Golff Filho Resident Doctor of Neurosurgery at Cajuru University Hospital, Brazil Author
  • Maria Carolina W de Jesus Medical Interns at Pontifical Catholic University of Paraná, Brazil Author
  • Samara V Tsukada Medical Interns at Pontifical Catholic University of Paraná, Brazil Author
  • Enrico Guido O Minniti Medical Interns at Pontifical Catholic University of Paraná, Brazil Author
  • Gustavo E Rambo Pianowski Medical Interns at Pontifical Catholic University of Paraná, Brazil Author
  • Lucas Peluzzo de Oliveira Medical Interns at Pontifical Catholic University of Paraná, Brazil Author
  • Luana Carolina Holler Santos Medical Interns at Pontifical Catholic University of Paraná, Brazil Author
  • Letícia Fernandes de Souza Porto Medical Interns at Pontifical Catholic University of Paraná, Brazil Author
  • Júlia Formes Dias Medical Interns at Pontifical Catholic University of Paraná, Brazil Author
  • Giulia Regina Colaço Bez Medical Interns at Pontifical Catholic University of Paraná, Brazil Author
  • Carolina Louise Bueno Haurani Medical Interns at Pontifical Catholic University of Paraná, Brazil Author
  • Débora Brighente Bertholdo Professor of Neuroradiology at Pontifical Catholic University of Paraná, Senior Researcher, Brazil Author

DOI:

https://doi.org/10.47363/JNRRR/2024(6)192

Keywords:

Glasgow Outcome Scale, Intracranial Hemorrhage, Traumatic Brain Injury, Glasgow Coma Scale

Abstract

Objectives: To establish a relationship between patient profiles, patterns of intracranial hemorrhage resulting from traumatic brain injury (TBI), and the outcomes measured by GOS.

Background: TBI can cause hemorrhages, which exhibit different clinical patterns and imaging findings, typically associated with a worse prognosis. The GOS is an important tool for measuring the functional capacity of post-TBI patients.

Methods: Retrospective cohort study. Included individuals above 18 years old with intracranial hemorrhage from TBI in the admission CT. The collected data were: gender; age; comorbidities; mechanism of trauma; GCS at the scene; presence of cranial fracture; presence, location, and extent of subdural, epidural, subarachnoid, and intraparenchymal hemorrhages; and number of affected lobes. At discharge, the association of these characteristics with 4 out of 5 GOS classifications was evaluated: death; severe disability; moderate disability; and mild disability/good recovery.

Results: 193 patients were included, with an average age of 49±20 years, predominantly male (78.8%). The majority (74.1%) were discharged with mild disability/good recovery, 6.2% with moderate disability, 5.2% with severe disability, 0.5% in a vegetative state, and 14% died. There was a significant association between having one injury and mild disability (residual: 4.1), two injuries and moderate disability (residual: 2.4), three injuries and severe disability (residual: 2.9), and four or more injuries and death (residual: 4.5). Another association was observed between mild TBI and mild disability (residual: 6.6), and between severe TBI and severe disability and death (residuals: 4.0 and 5.9, respectively). Death was also associated with cranial fracture (p=0.022 and residual: 2.6), temporal lobe injury (p=0.014 and residual: 2.5), tentorial subarachnoid hemorrhage (p=0.012 and residual: 2.8), and injuries in other locations (p=0.022 and residual: 3.0).

Conclusions: It was found that the more severe the TBI and the greater the number of cranial injuries, the worse the patient outcomes.

Author Biographies

  • Luiz Eduardo Kostin Felipe de Natividade, Medical Interns at Pontifical Catholic University of Paraná, Brazil

    Medical Interns at Pontifical Catholic University of Paraná, Brazil

  • Carlos Alberto Mattozo, Professor of Neurosurgery at Pontifical Catholic University of Paraná, Senior Researcher, Brazil

    Professor of Neurosurgery at Pontifical Catholic University of Paraná, Senior Researcher, Brazil

  • Ildo Valter Golff Filho, Resident Doctor of Neurosurgery at Cajuru University Hospital, Brazil

    Resident Doctor of Neurosurgery at Cajuru University Hospital, Brazil

  • Maria Carolina W de Jesus, Medical Interns at Pontifical Catholic University of Paraná, Brazil

    Medical Interns at Pontifical Catholic University of Paraná, Brazil

  • Samara V Tsukada, Medical Interns at Pontifical Catholic University of Paraná, Brazil

    Medical Interns at Pontifical Catholic University of Paraná, Brazil

  • Enrico Guido O Minniti, Medical Interns at Pontifical Catholic University of Paraná, Brazil

    Medical Interns at Pontifical Catholic University of Paraná, Brazil

  • Gustavo E Rambo Pianowski, Medical Interns at Pontifical Catholic University of Paraná, Brazil

    Medical Interns at Pontifical Catholic University of Paraná, Brazil

  • Lucas Peluzzo de Oliveira, Medical Interns at Pontifical Catholic University of Paraná, Brazil

    Medical Interns at Pontifical Catholic University of Paraná, Brazil

  • Luana Carolina Holler Santos, Medical Interns at Pontifical Catholic University of Paraná, Brazil

    Medical Interns at Pontifical Catholic University of Paraná, Brazil

  • Letícia Fernandes de Souza Porto, Medical Interns at Pontifical Catholic University of Paraná, Brazil

    Medical Interns at Pontifical Catholic University of Paraná, Brazil

  • Júlia Formes Dias, Medical Interns at Pontifical Catholic University of Paraná, Brazil

    Medical Interns at Pontifical Catholic University of Paraná, Brazil

  • Giulia Regina Colaço Bez, Medical Interns at Pontifical Catholic University of Paraná, Brazil

    Medical Interns at Pontifical Catholic University of Paraná, Brazil

  • Carolina Louise Bueno Haurani, Medical Interns at Pontifical Catholic University of Paraná, Brazil

    Medical Interns at Pontifical Catholic University of Paraná, Brazil

  • Débora Brighente Bertholdo, Professor of Neuroradiology at Pontifical Catholic University of Paraná, Senior Researcher, Brazil

    Professor of Neuroradiology at Pontifical Catholic University of Paraná, Senior Researcher, Brazil

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Published

2024-01-31

Issue

Vol. 6 No. 1 (2024): Volume 6 Issue 1

Section

Articles