جستجوی مقالات مرتبط با کلیدواژه « glasgow outcome scale » در نشریات گروه « پزشکی »

Sodium disorders are one of the most important electrolyte disorders among brain trauma patients.
The purpose of this study was to determine the frequency of hyponatremia in patients with moderate and severe brain trauma and its relationship with disease prognosis.
This descriptive-cross-sectional and prospective study was conducted on brain trauma patients visiting Kashani Hospital in Isfahan city in 2023. The obtained data was analyzed by SPSS 24.
Out of the 54 examined (23 severe TBI and 31 moderate TBI) patients, hypernatremia was observed in seven cases (13%), and hyponatremia was observed in 23 cases (42.7%). Hyponatremia on the first day had a significant relationship with the bad prognosis of the disease. In addition, a significant relationship was observed between the type of imaging findings and GOS, so that people who had ICH imaging findings were associated with a poorer prognosis p <0.05.
On the first day, hyponatremia had a significant prevalence in moderate and severe brain trauma patients, which was associated with a bad prognosis of the disease, and this relationship is not dependent on factors such as age, gender, and cause of trauma.

To probe the factors associated with the outcomes of traumatic brain injury (TBI) patients admittedto emergency department (ED). This is a cross-sectional study that data gathering was performed via census methods, retrospectively.During one year, all head injury’s patients who admitted to the ED of a tertiary center in Tehran, Iran wereincluded. Age, gender, mechanism of injury, Glasgow coma scale (GCS) and injury severity score (ISS)on admission, presence of extra-cranial injuries, findings of brain computed tomography (CT), duration ofhospitalization, and in hospital outcomes were recorded. Outcome’s assessment for survivors was performedwithin a 6 months-period after discharge based on Glasgow outcome scale (GOS). The variables and outcomes’association were assessed. Totally, 506 patients were evaluated with the mean age of 36.77±21.1 years that 411 (81.2%) were men.Follow up at 6-months post injury was feasible in 487 (96.2%) patients; 59 (11.7%) out of 506 eligible patientsdied. Logistic regression analysis showed the association between assessed variables and patients’ outcome asfollows: age>65 years (OR: 12.21; p<0.001), GCS on admission <8 (OR: 62.99; p<0.001), presence of traumaticIntracerebral hemorrhage (ICH) in brain CT scan (OR: 20.11; p=0.010), duration of hospitalization ≥ 5 days(OR: 0.28; p=0.001). The findings of the current study distinguished some variables that were associated with thepoor outcome of the patients with TBI. Therefore, TBI patients with any of these risk factors may need closecontinues monitoring, early ICU admission, and some other special extra care in ED.

Traumatic brain injury (TBI) is one of the causes of death wherein thyroid hormone concentrations are abnormally altered. This study aimed to assess thyroid function tests and the effect of levothyroxine on TBI and its outcome.

In this randomized clinical trial study, the TBI group Levothyroxine (50 mg) was administered twice daily for three days; the control group received a placebo in a similar pattern. The serum levels of T3, T4, and TSH were evaluated in 100 TBI patients on days 1 and 7. A questionnaire related to Disability was assessed using both Disability Rating Scale (DRS) and Glasgow Outcome Scale (GOS) scores. The obtained data were analyzed by SPSS version 20.

The mean levels of T3 and TSH in both groups were not significantly different. T4 levels of the patients receiving levothyroxine were significantly higher than the control group. The mean DRS scores at the time of discharge were lower in the levothyroxine group compared to the placebo group.

Our results showed that levothyroxine is effective in improving patients suffering moderate head trauma. Furthermore, the T4 serum level can be used as a prognostic factor in these patients.

TBI, standing for Traumatic Brain Injury, is a leading cause of death worldwide; nonetheless, data on its management has hitherto been sparse. In view of the fact that brain lobectomy is a contentious issue in the management of TBI, we set out the currentstudy to assess the mortality rate and outcomes of TBI with delayed contusion or Intracerebral Hemorrhage (ICH) undergoing lobectomy.

We evaluated 135 TBI patients with delayed contusion or ICH undergoing brain lobectomy from 2001 to 2013. Withal, the mortality and Glasgow Outcome Scale (GOS) and Glasgow Comma Scale (GCS) rates were assessed in these patients and the association in between was sought.

The TBI patients undergoing brain lobectomy (77% male versus 23 % female) had a mean age of 43.4±20.3 years and experienced a survival rate of 62.2% (71% in females versus 60% in males). Favorable GOS was observed in 53% of male patients, compared with 27% in the females. Age was demonstrated to significantly affect the mortality rate (p=0.0001). Initial GCS score was associated with GOS as 79.1% of the survived patients with a GCS of higher than 9 on admission were discharged with favorable GOS.

The evidence from the present study indicates that lobectomy can be an acceptable surgical procedure in management of TBI patients with delayed contusion or ICH.

Spinal cord injury (SCI) is one of the main causes of severe disability and mortality following trauma. Complications and outcomes of patients with spine trauma, especially those who undergo surgery, are a less divulged topic in Iran. Therefore, we designed the present study to evaluate complications and outcomes of patients with traumatic spine in Poursina hospital of Rasht.
Methods and Materials/Patients: In the present cross-sectional study, we referred to registry of spinal cord injuries of Poursina Hospital, which is a referral center for trauma in Rasht in the north of Iran. We investigated records of all the patients with traumatic spine confirmed by Computed Tomography (CT) scan or Magnetic Resonance Imaging (MRI) during 2016-2018. Demographic data, types of SCI, types of surgical interventions, time from injury to surgery, number of fixed and fused vertebrae, complications, and outcome (based on Glasgow Outcome Scale (GOS) criteria) of the patients were evaluated upon discharge.

In total, records of 274 patients with spine trauma were reviewed. The mean±SD of age of the patients was 42.27±16.83 years. There were 76 women (27.7%) and 198 males (72.3%). Surgical interventions were done for 148 patients (54%). The median of time of surgical interventions for displacement of the vertebrae and the median of time for removal of pressure from spinal cord in the patients were 5 hours (range =82 hours). Median of duration of hospital stay was 2 days (range =167 days). 2.2% of the patients experienced complications. 85% of the patients showed good recovery according to GOS.

The evidence from the present study indicates that approximately half of the patients with spine trauma underwent operation. Good recovery was seen in roughly four fifth of all of the patients with spine trauma. Most of the patients had no complications during their stay in the hospital.

Considering the role of Intracranial Pressure Amplitude [AMP(ICP)] in evaluating the rate of craniospinal compliance (CC) and intracranial pressure (ICP) and in estimating the degree of brain damage, the aim of the present study was to evaluate the correlation of AMP(ICP) with the degree of brain damage in patients with traumatic brain injury (TBI).

Thirty-four patients were enrolled in the present study. Patients underwent intraventricular ICP monitoring. During the first 24 hours, AMP(ICP) was recorded every hour, and its total mean was calculated. Correlation of AMP(ICP) and Glasgow outcome scale (GOS) was analyzed.

There was a negative correlation between mean AMP(ICP) within 24 hours and GOS values on the first, third, and sixth month (r = -0.476, -0.563, and -0.627, respectively).

The findings of the present study suggest that AMP(ICP) index can determine GOS in patients with TBI.

Decompressive craniectomy (DC) can be life-saving for patients with severe traumatic brain injury (TBI), but many questions about its ideal application, indications, timing, technique, and even the definition of success of DC remains unclear. The aim of this study was to assess the factors associated with prognosis and outcome of patients with TBI who had undergone a rapid decompressive craniectomy.
Methods and Materials/Patients: We investigated 61 patients, who had underwent rapid decompressive craniectomy. The effect of variables including demographic features of patients, primary level of consciousness, pupil size and reactivity, midline shift in patients brain CT scan on outcome of patients were assessed.
Sixty-one patients (36 males and 25 females) underwent rapid surgical DC within 4.5 ± 2 hours after trauma. Mean age of patients was 36.09± 15.89 years old (range 16 to 68). Of 61 patients, 33 (54.1%) had favorable and 28 (45.9%) had unfavorable outcome. Patients with following conditions had significantly worse outcome; older than 60 years, bilateral non-reactive mydriasis, critical head injury (GCS 10 mm had 6.15 times more risk of unfavorable outcome compared to those with lower than 10 mm of midline shift.
In this study we found that age more than sixty years and GCS less than five were associated with poor outcome. Patients with these conditions could not benefit much from early DC.

Traumatic Brain Injury (TBI) is the leading cause of mortality and morbidity especially in young ages. Despite over 30 years of using Neuroprotective agents for TBI management, there is no absolute recommended agent for the condition yet.
This study is a part of a scoping review thesis on "Neuroprotective agents using for Traumatic Brain Injury: a systematic review & meta-analyses"; which had a wide proposal keywords and ran in "Cochrane CENTRAL", "MedLine/PubMed", "SCOPUS", "Thomson Reuters Web of Science", "SID.ir", "Barket Foundation", and "clinicaltrials.gov" databases up to September 06, 2015. This study limits the retrieved search results only to those which used citicoline for TBI management. The included Randomized Clinical Trial's (RCTs) were assessed for their quality of reporting by adapting CONSORT-checklist prior to extracting their data into meta-analysis. Meta-analyses of this review were conducted by Glasgow Outcome Scale (GOS) in acute TBI patients and total neuropsychological assessments in both acute and chronic TBI management, mortalities and adverse-effects.
Four RCTs were retrieved and included in this review with 1196 participants (10 were chronic TBI impaired patients); analysis of 1128 patients for their favorable GOS outcomes in two studies showed no significant difference between the study groups; however, neuropsychological outcomes were significantly better in placebo/control group of 971 patients of three studies. Mortality rates and adverse-effects analysis based on two studies with 1429 patients showed no significant difference between the study groups. However, two other studies have neither mortality nor adverse effects reports due to their protocol.
Citicoline use for acute TBI seems to have no field of support anymore, whereas it may have some benefits in improving the neuro-cognitive state in chronic TBI patients. It's also recommended to keep in mind acute interventions like Psychological First Aid (PFA) during acute TBI management.

Traumatic brain injury (TBI) is one of the important causes of morbidity and mortality throughout the world, especially in young people. In recent years normobaric hyperoxia has become an important and useful step for recovery and improvement of outcome in TBI.

The purpose of this study was to evaluate the effects of normobaric hyperoxia on clinical neurological outcomes of patients with severe traumatic brain injuries. We used the Glasgow outcome scale (GOS), barthel index, and modified rankin scale (mRS) to measure the outcomes of patients with TBI.

Sixty-eight consecutive patients with severe TBI (mean Glasgow coma scale [GCS] score: 7.4) who met the inclusion criteria were entered in this randomized controlled clinical trial. The patients were randomized into two groups, as follows: 1) experimental: received 80% oxygen via mechanical ventilator in the first 6 hours of admission, 2) control: received 50% oxygen by mechanical ventilator in the first 6 hours of admission and then standard medical care. We measured the GOS, Barthel Index, and mRS at the time of discharge from hospital and reassessed these measurements at the 6-month follow-up after injury.

According to our study, there were no significant sex or age differences between the two groups (P = 0.595 and 0.074). The number of days in the intensive care unit (ICU) in the control group and experimental group were 11.4 and 9.4 days, respectively (P = 0.28), while the numbers of days of general ward admission were 13.9 and 11.4 days (P = 0.137) respectively. The status of GOS at time of discharge were severe = 13 and 10, moderate = 16 and 19, and low = 5 and 5 in the control and experimental groups, respectively (P = 0.723); 6 months after injury, the scores were as follows: moderate = 16 and 9, low = 15 and 25, and severe = 3 and 0 (P = 0.024). The Barthel index scores in the control and experimental groups were 59.7 and 63.9 at time of discharge (P = 0.369) and 82.7 and 91.3 at 6 months after injury (P = 0.018), respectively. The mRS results were 2.6 and 2.3 at time of discharge (P = 0.320) and 1.6 and 0.7 at 6 months after injury (P = 0.006) for the control and experimental groups, respectively.

According to the results of this study, oxygen therapy by mechanical ventilator in the first 6 hours after injury in patients with severe TBI can improve the final GOS, Barthel index, and mRS scores. It could also improve long-term outcomes and enhance rehabilitation and the quality of life.