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Chapter 10
Author(s) -
Hamid Hashemi
Publication year - 1995
Publication title -
acta neurologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.967
H-Index - 95
eISSN - 1600-0404
pISSN - 0001-6314
DOI - 10.1111/j.1600-0404.1995.tb01712.x
Subject(s) - citation , information retrieval , computer science , library science , medicine , psychology
In Chapter 2, the background for the choice of PTA as an early indicator of TBI severity and predictor of outcome was described. As mentioned in Chapter 3 , repeated assessments of the Glasgow Coma Score=GCS (48) were made until the patient was fully conscious or stable at a lower level of consciousness. Furthermore, the initial total trauma severity was assessed as the ISS, or Injury Severity Score (53, 61), basically assessing injuries including bone fracturesand not the resulting impairments and disabilities. Overall outcome was assessed at one and two years of injury by the extended version from 1981 (234) of the Glasgow Outcome Score (40). In Table R10, the patients are sorted according to decreasing PTA, the main single criterion in the present study for the severity of TBI with regard to the long term prognosis. For the core group of 24 patients with PTA >1 week, PTA was between one and two weeks in seven, between two and four weeks in eight, and above four weeks in nine patients. Median PTA for the group of 24 patients was 21 days, equal for males and females. At the two year follow up, one patient was still in a state of PTA. It was mentioned earlier that since patients with PTA between 24 hours and one week were not readily identified in the emergency rooms, the lower limit of PTA was set at one week in stead of the originally planned 24 hours. However, the ten patients with PTA I week would be classified as severely injured. Other criteria of severity, namely best GCS in the first 24 hours of trauma and the number of days before the patients were out of coma (i.e. reached a GCS score of at least 9) are also shown in Table R10. Furthermore, Table R10 shows the total initial trauma severity assessed by the ISS =Injury Severity Scale score. Maximun ISS=75 was assigned to pt.3 who beyond the TBI suffered a C2 fracture with a complete cervical cord syndrome (tetraplegia). Finally, Table R10 shows assessments of overall outcomes according to the 1981 version of the Glasgow Outcome Score (GOS) one and two years of trauma. (Note that according to this version (234), increasing scores correspond to increasing disability). With regard to outcome, it appears from Table R 10 that: