Al-Hassani Ammar, Strandvik Gustav F, El-Menyar Ayman, Dhumale Amit R, Asim Mohammed, Ajaj Ahmed, Al-Yazeedi Wafa, Al-Thani Hassan
Department of Surgery, Trauma Surgery Section, Hamad General Hospital, Doha, Qatar.
Department of Surgery, Trauma Surgery Section, Clinical Research, Hamad General Hospital, Doha, Qatar.
J Emerg Trauma Shock. 2018 Jul-Sep;11(3):197-204. doi: 10.4103/JETS.JETS_6_18.
We aimed to analyze the functional outcomes based on the admission characteristics in individuals with moderate-to-severe traumatic brain injury (TBI) over a 5-year period.
A retrospective cohort study was conducted to assess the cognitive, physical, and functional outcomes based on traditional and novel metrics used in potential outcome prediction.
A total of 201 participants were enrolled with a mean age of 31.9 ± 11.9 years. Glasgow Coma Score (GCS) at emergency department did not correlate with the functional independence measure (FIM) score or Ranchos Los Amigos (RLA) scores at discharge. The absolute functional gain was significantly higher in individuals who sustained TBI with RLA 4-5 (34.7 ± 18.8 vs. 26.5 ± 15.9, = 0.006). Participants with RLA 4-5 on admission to rehabilitation showed good correlation with the absolute FIM gain. On multivariate regression analysis, only age (odds ratio 0.96; 95% confidence interval: 0.93-0.98; = 0.005) was found to be the independent predictor of good functional outcome.
Initial GCS is not a predictor of functional outcome in individuals who sustained TBI. Consideration of age and development of novel functional measures might be promising to predict the outcomes in individuals with moderate-to-severe TBI.
我们旨在分析中度至重度创伤性脑损伤（TBI）患者在5年期间基于入院特征的功能结局。
进行了一项回顾性队列研究，以根据潜在结局预测中使用的传统和新指标评估认知、身体和功能结局。
共纳入201名参与者，平均年龄为31.9±11.9岁。急诊科的格拉斯哥昏迷量表（GCS）与出院时的功能独立性测量（FIM）评分或Rancho Los Amigos（RLA）评分无关。RLA为4-5级的TBI患者的绝对功能改善显著更高（34.7±18.8对26.5±15.9，P=0.006）。康复入院时RLA为4-5级的参与者与FIM绝对改善具有良好的相关性。多因素回归分析显示，仅年龄（比值比0.96；95%置信区间：0.93-0.98；P=0.005）是功能结局良好的独立预测因素。
初始GCS不是TBI患者功能结局的预测指标。考虑年龄和开发新的功能测量方法可能有助于预测中度至重度TBI患者的结局。
