Usefulness of the Abbreviated Injury Score and the Injury Severity Score in Comparison to the Glasgow Coma Scale in Predicting Outcome After Traumatic Brain Injury

2007 ◽  
Vol 62 (4) ◽  
pp. 946-950 ◽  
Author(s):  
Brandon P. Foreman ◽  
R Ruth Caesar ◽  
Jennifer Parks ◽  
Christopher Madden ◽  
Larry M. Gentilello ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Glasgow Coma Scale ◽  
Injury Severity Score ◽  
Severity Score ◽  
Injury Severity ◽  
Injury Score ◽  
Coma Scale ◽  
Predicting Outcome ◽  
Abbreviated Injury Score

Penetrating brain injury: a case of survival following blast fragmentation injuries to the head

2013 ◽  
Vol 99 (2) ◽  
pp. 55-56
Author(s):  
J McKinlay ◽  
JE Smith
Keyword(s):  
Brain Injury ◽  
Glasgow Coma Scale ◽  
Injury Severity Score ◽  
Severity Score ◽  
Injury Severity ◽  
Head Injuries ◽  
Good Recovery ◽  
Coma Scale ◽  
Blast Fragmentation ◽  
Serious Injuries

AbstractWe present a case of penetrating head injuries caused by blast fragmentation, along with other serious injuries (including to the arms, face and neck), where a good recovery was made despite an Injury Severity Score (ISS) of 75. We suggest that survival and outcome are reliant on several factors and cannot be predicted from ISS, velocity of penetrating injury or presenting Glasgow Coma Scale (GCS) alone.

Blast Injury in a Civilian Trauma Setting is Associated with a Delay in Diagnosis of Traumatic Brain Injury

2008 ◽  
Vol 74 (3) ◽  
pp. 267-270 ◽  
Author(s):  
Grant V. Bochicchio ◽  
Kimberly Lumpkins ◽  
James O'Connor ◽  
Marc Simard ◽  
Stacey Schaub ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Glasgow Coma Scale ◽  
Scale Score ◽  
Glasgow Coma Scale Score ◽  
Injury Severity ◽  
Disease Process ◽  
Blast Injury ◽  
Coma Scale ◽  
The Mean

High-pressure waves (blast) account for the majority of combat injuries and are becoming increasingly common in terrorist attacks. To our knowledge, there are no data evaluating the epidemiology of blast injury in a domestic nonterrorist setting. Data were analyzed retrospectively on patients admitted with any type of blast injury over a 10-year period at a busy urban trauma center. Injuries were classified by etiology of explosion and anatomical location. Eighty-nine cases of blast injury were identified in 57,392 patients (0.2%) treated over the study period. The majority of patients were male (78%) with a mean age of 40 ± 17 years. The mean Injury Severity Score was 13 ± 11 with an admission Trauma and Injury Severity Score of 0.9 ± 0.2 and Revised Trauma Score of 7.5 ± 0.8. The mean intensive care unit and hospital length of stay was 2 ± 7 days and 4.6 ± 10 days, respectively, with an overall mortality rate of 4.5 per cent. Private dwelling explosion [n = 31 (35%)] was the most common etiology followed by industrial pressure blast [n = 20 (22%)], industrial gas explosion [n = 16 (18%)], military training-related explosion [n = 15 (17%)], home explosive device [n = 8 (9%)], and fireworks explosion [n = 1 (1%)]. Maxillofacial injuries were the most common injury (n = 78) followed by upper extremity orthopedic (n = 29), head injury (n = 32), abdominal (n = 30), lower extremity orthopedic (n = 29), and thoracic (n = 19). The majority of patients with head injury [28 of 32 (88%)] presented with a Glasgow Coma Scale score of 15. CT scans on admission were initially positive for brain injury in 14 of 28 patients (50%). Seven patients (25%) who did not have a CT scan on admission had a CT performed later in their hospital course as a result of mental status change and were positive for traumatic brain injury (TBI). Three patients (11%) had a negative admission CT with a subsequently positive CT for TBI over the next 48 hours. The remaining four patients (14%) were diagnosed with skull fractures. All patients (n = 4) with an admission Glasgow Coma Scale score of less than 8 died from diffuse axonal injury. Blast injury is a complicated disease process, which may evolve over time, particularly with TBI. The missed injury rate for TBI in patients with a Glasgow Coma Scale score of 15 was 36 per cent. More studies are needed in the area of blast injury to better understand this disease process.

scholarly journals Prediction of outcome based on trauma and injury severity score, IMPACT and CRASH prognostic models in moderate-to-severe traumatic brain injury in the elderly

2021 ◽  
Vol 16 (3) ◽  
pp. 500
Author(s):  
DhoniGanesh Siva Rama Krishna Moorthy ◽  
Krishnappa Rajesh ◽  
SarathyManju Priya ◽  
Thaminaina Abhinov ◽  
KalavaguntaJyothiswarapillai Devendra Prasad
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Injury Severity Score ◽  
Severe Traumatic Brain Injury ◽  
Severity Score ◽  
Injury Severity ◽  
The Elderly ◽  
Prognostic Models ◽  
Prediction Of Outcome ◽  
Trauma And Injury

scholarly journals Delayed Sequelae Related to Mild Traumatic Brain Injury in Children

2020 ◽  
Vol 7 ◽  
pp. 2333794X2094798
Author(s):  
Akella Chendrasekhar ◽  
Brandon Kuczabski ◽  
Douglas Cohen ◽  
Melissa Grageda ◽  
Daniel Genovese-Scullin ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Injury Severity Score ◽  
Mild Traumatic Brain Injury ◽  
Severity Score ◽  
Injury Severity ◽  
Case Reports ◽  
Residual Effects ◽  
Concussive Injury

Delayed sequelae from mild traumatic brain injury (Glasgow Coma Score at admission >13, TBI) has been documented in case reports however larger studies of these effects are sparse. We undertook a telephone based survey to assess the long term sequelae of TBI. We tracked 100 pediatric TBI patients via our trauma registry for demographic data including age, injury severity, and mechanism of injury. Then we proceeded to contact these patient’s parents via telephone. We asked regarding residual symptoms and signs of concussive injury. Duration out from initial concussive injury ranged from 4 to 68 months. The parents of 66 boys and 34 girls were surveyed. The age of the patients at the time of mild TBI ranged from 1 to 14 years. The injury severity score ranged from 1 to 21. One being the most common Injury severity score. Thirty-three percent of patients had residual effects of concussion at the time of telephone survey. Fourteen percent had memory loss issues, 21% had anxiety/depression issues, 20% had learning disability issues, and 15% had sleep disturbance issues. Duration of time post concussive injury, mechanism, and age did not influence incidence of sequelae. Mild traumatic brain injury has significant long term sequelae. Better identifying characteristics are needed to characterize patients susceptible to long term residual effects of concussion.

Is Routine Continuous EEG for Traumatic Brain Injury Beneficial?

2017 ◽  
Vol 83 (12) ◽  
pp. 1433-1437 ◽  
Author(s):  
Lia Aquino ◽  
Christopher Y. Kang ◽  
Megan Y. Harada ◽  
Ara Ko ◽  
Amy Do-nguyen ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Injury Severity ◽  
Trauma Patients ◽  
Injury Score ◽  
Increased Risk ◽  
Continuous Eeg ◽  
Severe Tbi ◽  
Level I ◽  
Abbreviated Injury Score

Severe traumatic brain injury (TBI) is associated with increased risk for early clinical and sub-clinical seizures. The use of continuous electroencephalography (cEEG) monitoring after TBI allows for identification and treatment of seizures that may otherwise occur undetected. Benefits of “routine” cEEG after TBI remain controversial. We examined the rate of subclinical seizures identified by cEEG in TBI patients admitted to a Level I trauma center. We analyzed a cohort of trauma patients with moderate to severe TBI (head Abbreviated Injury Score ≥3) who received cEEG within seven days of admission between October 2011 and May 2015. Demographics, clinical data, injury severity, and costs were recorded. Clinical characteristics were compared between those with and without seizures as identified by cEEG. A total of 106 TBI patients with moderate to severe TBI received a cEEG during the study period. Most were male (74%) with a mean age of 55 years. Subclinical seizures were identified by cEEG in only 3.8 per cent of patients. Ninety-three per cent were on antiseizure prophylaxis at the time of cEEG. Patients who had subclinical seizures were significantly older than their counterparts (80 vs 54 years, P = 0.03) with a higher mean head Abbreviated Injury Score (5.0 vs 4.0, P = 0.01). Mortality and intensive care unit stay were similar in both groups. Of all TBI patients who were monitored with cEEG, seizures were identified in only 3.8 per cent. Seizures were more likely to occur in older patients with severe head injury. Given the high cost of routine cEEG and the low incidence of subclinical seizures, we recommend cEEG monitoring only when clinically indicated.

Limitations of the Glasgow Coma Scale in predicting outcome in children with traumatic brain injury

1992 ◽  
Vol 120 (2) ◽  
pp. 195-199 ◽  
Author(s):  
Mary W. Lieh-Lai ◽  
Andreas A. Theodorou ◽  
Ashok P. Sarnaik ◽  
Kathleen L. Meert ◽  
Patricia M. Moylan ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Glasgow Coma Scale ◽  
Coma Scale ◽  
Predicting Outcome

Activation of Massive Transfusion for Elderly Trauma Patients

2015 ◽  
Vol 81 (10) ◽  
pp. 945-949 ◽  
Author(s):  
Jason S. Murry ◽  
Andrea A. Zaw ◽  
David M. Hoang ◽  
Devorah Mehrzadi ◽  
Danielle Tran ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Glasgow Coma Scale ◽  
Injury Severity Score ◽  
Severity Score ◽  
Injury Severity ◽  
Massive Transfusion ◽  
Hospital Length Of Stay ◽  
Trauma Patients ◽  
Coma Scale ◽  
Elderly Trauma Patients

Massive transfusion protocol (MTP) is used to resuscitate patients in hemorrhagic shock. Our goal was to review MTP use in the elderly. All trauma patients who required activation of MTP at an urban Level I trauma center from January 1, 2011 to December 31, 2013 were reviewed retrospectively. Elderly was defined as age ≥ 60 years. Sixty-six patients had MTP activated: 52 non-elderly (NE) and 14 elderly (E). There were no statistically significant differences between the two cohorts for gender, injury severity score, head abbreviated injury scale, emergency department Glasgow Coma Scale, initial hematocrit, intensive care unit length of stay, or hospital length of stay. Mean age for NE was 35 years and 73 years for E ( P < 0.01). Less than half (43%) of E patients with activation of MTP received 10 or more units of blood products compared with 69 per cent of the NE ( P = 0.07). Mortality rates were similar in the NE and the E (53% vs 50%, P = 0.80). After multivariate analysis with Glasgow Coma Scale, injury severity score, and blunt versus penetrating trauma, elderly age was not a predictor of mortality after MTP ( P = 0.35). When MTP is activated, survival to discharge in elderly trauma patients is comparable to younger patients.

Supermassive Transfusion: A 15-Year Single Center Experience and Outcomes

2018 ◽  
Vol 84 (10) ◽  
pp. 1617-1621 ◽  
Author(s):  
Alison J. Yu ◽  
Kenji Inaba ◽  
Subarna Biswas ◽  
Luis Alejandro De Leon ◽  
Monica Wong ◽  
...  
Keyword(s):  
Glasgow Coma Scale ◽  
Injury Severity Score ◽  
Severity Score ◽  
Injury Severity ◽  
Characteristic Curve ◽  
Univariate Analysis ◽  
Female Gender ◽  
Trauma Patients ◽  
Coma Scale ◽  
Single Center Experience

The objective of this study was to determine the survival outcome associated with large-volume blood transfusion after trauma. This was a retrospective study at a Level I trauma center from January 2000 to December 2014 that included trauma patients who received ≥25 units packed red blood cell (pRBC) within the first 24 hours of hospital admission. Univariate and multivariable logistic regressions identified risk factors for mortality. Receiver operating characteristic curve analysis evaluated the ability of pRBC volume to predict mortality. Among 74,065 adults (‡18 years old), 178 patients (0.24%) received ≥25 units of pRBC in the first 24 hours, of which 142 (79.8%) received 25 to 49 units, 28 (15.7%) received 50 to 74 units, and 8 (4.5%) received ≥75 units. Overall, 92.2 per cent were male, mean age 33.9 (614.0), mean Injury Severity Score 28.9 (614.3), and median Glasgow Coma Scale score 12 (3–15). The overall mortality was 65.2 per cent and 64.1 per cent for those receiving 25 to 49 units, 64.3 per cent for 50 to 74 units, and 87.5 per cent for ≥75 units. In univariate analysis, female gender was associated with lower mortality [odds ratio (OR) 0.24, P = 0.025]. Decreasing Glasgow Coma Scale (OR 0.82, P < 0.001), increasing Injury Severity Score (OR 1.07, P < 0.001), and thoracotomy (OR 3.91, P < 0.001) were associated with higher mortality. There was no transfusion cutoff that was significantly associated with higher mortality.

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