scholarly journals Traumatic brain injury in children in Moscow

2021 ◽  
Vol 2 (2) ◽  
pp. 35-45
Author(s):  
Elizaveta А. Sharova ◽  
Svetlana А. Valiullina
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Objective Assessment ◽  
High Morbidity ◽  
Risk Area ◽  
High Risk Area ◽  
Unnatural Death ◽  
Incidence And Mortality ◽  
Social Statistics ◽  
Type Of Injury

Traumatic brain injury (TBI) is the main cause of unnatural death and disability in the child population, ranking first among all injuries requiring hospitalization. The lack of full and detailed medical and social statistics on the prevalence of TBI and its consequences impedes their reasonable assessment and reduces the possibility of prevention. The aim is to study and assess the current epidemiological situation of TBI in children in Moscow. Materials and methods. Comparative study of main trends in the incidence and mortality of TBI in children in Moscow in 2003–2018 with the average Russian indicators based on state statistical data. Results and conclusions. Megacities are a high risk area for TBI in children, therefore policies require additional prevention strategies. Limitations in the existing forms for state statistics impede an objective assessment and establishment of true levels of morbidity and mortality in children from TBI, as well as identification of its causes. Increased hospitalization rate of children with TBI in Moscow at high morbidity levels contributes to low mortality and lethality rates in children from this type of injury.

scholarly journals Fine Tuning of Traumatic Brain Injury Management in Neurointensive Care—Indicative Observations and Future Perspectives

2021 ◽  
Vol 12 ◽  
Author(s):  
Teodor M. Svedung Wettervik ◽  
Anders Lewén ◽  
Per Enblad
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Fine Tuning ◽  
Neurointensive Care ◽  
Secondary Brain Injury ◽  
Brain Tissue Oxygenation ◽  
Treatment Protocols ◽  
Injury Mechanisms ◽  
Severe Tbi ◽  
Type Of Injury

Neurointensive care (NIC) has contributed to great improvements in clinical outcomes for patients with severe traumatic brain injury (TBI) by preventing, detecting, and treating secondary insults and thereby reducing secondary brain injury. Traditional NIC management has mainly focused on generally applicable escalated treatment protocols to avoid high intracranial pressure (ICP) and to keep the cerebral perfusion pressure (CPP) at sufficiently high levels. However, TBI is a very heterogeneous disease regarding the type of injury, age, comorbidity, secondary injury mechanisms, etc. In recent years, the introduction of multimodality monitoring, including, e.g., pressure autoregulation, brain tissue oxygenation, and cerebral energy metabolism, in addition to ICP and CPP, has increased the understanding of the complex pathophysiology and the physiological effects of treatments in this condition. In this article, we will present some potential future approaches for more individualized patient management and fine-tuning of NIC, taking advantage of multimodal monitoring to further improve outcome after severe TBI.

A Nationwide Study of Incidence and Mortality Due to Traumatic Brain Injury in Ecuador (2004–2016)

2019 ◽  
Vol 54 (1) ◽  
pp. 33-44
Author(s):  
Esteban Ortiz-Prado ◽  
Guido Mascialino ◽  
Clara Paz ◽  
Alberto Rodriguez-Lorenzana ◽  
Lenin Gómez-Barreno ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Nationwide Study ◽  
Incidence And Mortality

scholarly journals Prognostic Value of Admission Parameters in a Machine Learning Predictive Model in Patients With Severe Traumatic Brain Injury and Acute Subdural Hematomas

Neurosurgery ◽  
2019 ◽  
Vol 66 (Supplement_1) ◽  
Author(s):  
Kevin John ◽  
Aaron McPheters ◽  
Andrew Donovan ◽  
Nicolas K Khattar ◽  
Jacob R Shpilberg ◽  
...  
Keyword(s):  
Machine Learning ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Predictive Model ◽  
Severe Traumatic Brain Injury ◽  
Acute Subdural Hematoma ◽  
High Morbidity ◽  
Radiographic Findings ◽  
Severe Tbi

Abstract INTRODUCTION Acute subdural hematoma (aSDH) in the context of severe traumatic brain injury (TBI) is a neurosurgical emergency. Predictive models have been used in an attempt to modulate the morbidity and mortality of patient outcomes. We used machine learning (ML) to identify admission risk factors predictive of long-term morbidity in the severe TBI patient population with aSDH. METHODS Between 2013 and 2016, 85 patients with severe TBI and aSDH were included in the analysis. Random forest, ML architecture, was used to create a predictive model of long-term morbidity stratification. About 46 patients were included in the high morbidity group [Glasgow Outcome Scale (GOS) 1-2] and 39 patients were in the low morbidity group (GOS 3-5). We included 30 admission input variables including medical and surgical co-morbidities, neurological examination, laboratory values, and radiographic findings. RESULTS The predictive model showed a 78% precision. The highest scoring input variable was the pupillary examination in predicting high vs low morbidity (bilaterally unreactive vs symmetrically reactive; P < .0001). GCS on admission was higher in the low morbidity group (4 [3-7] vs 7 [3-7]; P < .0101). Rotterdam scores were higher in the high-morbidity group (3 [3-5] vs 4 [4-5]; P < .0032). GCS motor examination on admission was higher in the low-morbidity group (5 [1-5] vs. 2 [1-5]; P < .0106). The basal cisterns were found to be more patent in patients with the low-morbidity group (P = .0012). CONCLUSION ML is an efficient tool that can provide a reasonable level of accuracy in predicting long-term morbidity in patients with severe TBI and aSDH. Monitoring these admission criteria can help with risk-stratification of patients into higher and low risk tracks. Integration of ML into the treatment algorithm may allow the development of more refined guidelines to guide goal-directed therapy.

scholarly journals Analysis of direct costs of decompressive craniectomy in victims of traumatic brain injury

2018 ◽  
Vol 76 (4) ◽  
pp. 257-264 ◽  
Author(s):  
Guilherme Lellis Badke ◽  
João Luiz Vitorino Araujo ◽  
Flávio Key Miura ◽  
Vinicius Monteiro de Paula Guirado ◽  
Nelson Saade ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Developing Country ◽  
Decompressive Craniectomy ◽  
Direct Costs ◽  
High Morbidity ◽  
Prevention Measures ◽  
Total Cost ◽  
Mortality Index ◽  
Epidemiological Profile

ABSTRACT Background: Decompressive craniectomy is a procedure required in some cases of traumatic brain injury (TBI). This manuscript evaluates the direct costs and outcomes of decompressive craniectomy for TBI in a developing country and describes the epidemiological profile. Methods: A retrospective study was performed using a five-year neurosurgical database, taking a sample of patients with TBI who underwent decompressive craniectomy. Several variables were considered and a formula was developed for calculating the total cost. Results: Most patients had multiple brain lesions and the majority (69.0%) developed an infectious complication. The general mortality index was 68.8%. The total cost was R$ 2,116,960.22 (US$ 661,550.06) and the mean patient cost was R$ 66,155.00 (US$ 20,673.44). Conclusions: Decompressive craniectomy for TBI is an expensive procedure that is also associated with high morbidity and mortality. This was the first study performed in a developing country that aimed to evaluate the direct costs. Prevention measures should be a priority.

scholarly journals Profile of Airway Patency, Respiratory Rate, PaCO2, and PaO2 in Severe Traumatic Brain Injury Patients (GCS <9) In Emergency Room Dr. Soetomo Hospital Surabaya

2020 ◽  
Vol 1 (2) ◽  
pp. 32
Author(s):  
Maria Marind Desrianti Hutauruk ◽  
Ira Dharmawati ◽  
Philia Setiawan
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Emergency Room ◽  
Respiratory Rate ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
High Morbidity ◽  
Academic Hospital ◽  
Airway Patency ◽  
Severe Tbi

Introduction: Traumatic Brain Injury (TBI) is the most common neurotrauma with high morbidity and mortality. Many guidelines recommend the use of mechanical ventilation for severe TBI patients, but there are limited resources of procuring ventilator machine in hospitals especially in developing countries. Yet it is not comparable with the number of TBI patients. Objective: This study is purposed to provide the profile of ventilation and oxygenation (airway patency, RR, PaCO2, and PaO2) in severe TBI patients (GCS<9) admitted in the Emergency Room (ER) of Dr. Soetomo General Academic Hospital Surabaya. Method and Material: This is a retrospective study using medical records of patients with TBI who were admitted in the ER of Dr. Soetomo General Academic Hospital from January to December 2017. The patient's general characteristics, blood gas analysis (PaCO2, PaO2), airway patency were recorded and analyzed. Results and Discussion: Thirty-seven severe TBI patients were included in the analysis. 30 men (81.1%) and 7 women (18.9%) with an average of 37±16 years old (range: 5-65) were studied. Most of the patients (94.6%) had MAP between 60 and 160 mmHg, PaCO2<35 mmHg (72.9%), PaO2>60 mmHg (100%), RR>20 breaths per minute (70.2%), and patent airways (64.9%) with simple support of oxygen. 8.1% of all of those patients had PaCO2>45 mmHg. Conclusion: Most of the severe TBI admitted in the ER of Dr. Soetomo General Academic Hospital had hypocapnia or respiratory rate higher than the normal range. Though one-third of the patient has partial obstruction of the airway, no significant hypoxemia is found.

Traumatic brain injury in Portugal: progress in incidence and mortality

Brain Injury ◽  
2019 ◽  
Vol 33 (12) ◽  
pp. 1552-1555 ◽  
Author(s):  
Maria Emilia Santos ◽  
Nicole Agrela
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Incidence And Mortality

scholarly journals Basal Cisternostomy in Traumatic Brain Injury: An Idea whose Time has Come?

2020 ◽  
Vol 17 (01) ◽  
pp. 03-05 ◽  
Author(s):  
Nishant Goyal ◽  
Punit Kumar ◽  
Jitender Chaturvedi ◽  
Saquib Azad Siddiqui ◽  
Deepak Agrawal
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Decompressive Craniectomy ◽  
Morbidity And Mortality ◽  
Great Promise ◽  
High Morbidity

AbstractTraumatic brain injury is associated with high morbidity and mortality. Since the introduction of decompressive craniectomy more than a century ago, no major surgical advancement has been introduced in this field in spite of neurosurgery having seen a sea change in general. Basal cisternostomy, introduced recently, is said to have great promise. In this regard, neurosurgeons need to understand the theory behind the recently introduced basal cisternostomy and whether it holds any merit or not.

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