Outcome in Patients with Isolated Moderate to Severe Traumatic Brain Injury
Joint Authors
Leenen, Loek
Houwert, Roderick M.
Jochems, D.
van Wessem, K. J. P.
Brouwers, H. B.
Dankbaar, J. W.
van Es, M. A.
Geurts, M.
Slooter, A. J. C.
Source
Critical Care Research and Practice
Issue
Vol. 2018, Issue 2018 (31 Dec. 2018), pp.1-7, 7 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2018-09-23
Country of Publication
Egypt
No. of Pages
7
Main Subjects
Abstract EN
Introduction.
Traumatic brain injury (TBI) remains a major cause of death.
Withdrawal of life-sustaining treatment (WLST) can be initiated if there is little anticipated chance of recovery to an acceptable quality of life.
The aim of this study was firstly to investigate WLST rates in patients with moderate to severe isolated TBI and secondly to assess outcome data in the survivor group.
Material and Methods.
A retrospective cohort study was performed.
Patients aged ≥ 18 years with moderate or severe isolated TBI admitted to the ICU of a single academic hospital between 2011 and 2015 were included.
Exclusion criteria were isolated spinal cord injury and referrals to and from other hospitals.
Gathered data included demographics, mortality, cause of death, WLST, and Glasgow Outcome Scale (GOS) score after three months.
Good functional outcome was defined as GOS > 3.
Results.
Of 367 patients, 179 patients were included after applying inclusion and exclusion criteria.
55 died during admission (33%), of whom 45 (82%) after WLST.
Patients undergoing WLST were older, had worse neurological performance at presentation, and had more radiological abnormalities than patients without WLST.
The decision to withdraw life-sustaining treatment was made on the day of admission in 40% of patients.
In 33% of these patients, this decision was made while the patient was in the Emergency Department.
71% of survivors had a good functional outcome after three months.
No patient left hospital with an unresponsive wakefulness syndrome (UWS) or suffered from UWS after three months.
One patient died within three months of discharge.
Conclusion.
In-hospital mortality in isolated brain injured patients was 33%.
The vast majority died after a decision to withdraw life-sustaining treatment.
None of the patients were discharged with an unresponsive wakefulness syndrome.
American Psychological Association (APA)
Jochems, D.& van Wessem, K. J. P.& Houwert, Roderick M.& Brouwers, H. B.& Dankbaar, J. W.& van Es, M. A.…[et al.]. 2018. Outcome in Patients with Isolated Moderate to Severe Traumatic Brain Injury. Critical Care Research and Practice،Vol. 2018, no. 2018, pp.1-7.
https://search.emarefa.net/detail/BIM-1130427
Modern Language Association (MLA)
Jochems, D.…[et al.]. Outcome in Patients with Isolated Moderate to Severe Traumatic Brain Injury. Critical Care Research and Practice No. 2018 (2018), pp.1-7.
https://search.emarefa.net/detail/BIM-1130427
American Medical Association (AMA)
Jochems, D.& van Wessem, K. J. P.& Houwert, Roderick M.& Brouwers, H. B.& Dankbaar, J. W.& van Es, M. A.…[et al.]. Outcome in Patients with Isolated Moderate to Severe Traumatic Brain Injury. Critical Care Research and Practice. 2018. Vol. 2018, no. 2018, pp.1-7.
https://search.emarefa.net/detail/BIM-1130427
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1130427