Artikel
Prospective monocentric validation of the Impact Prognostic Calculator after traumatic brain injury
Suche in Medline nach
Autoren
-
Uwe Planitzer
- Universitätsklinikum Leipzig, Klinik und Poliklinik für Neurochirurgie, Leipzig, Deutschland
-
Felix Arlt
- Universitätsklinikum Leipzig, Klinik und Poliklinik für Neurochirurgie, Leipzig, Deutschland
-
Jürgen Meixensberger
- Universitätsklinikum Leipzig, Klinik und Poliklinik für Neurochirurgie, Leipzig, Deutschland
| Veröffentlicht: | 18. Juni 2018 |
|---|
Gliederung
Text
Objective: Severe traumatic brain injury (TBI) is one of the most common causes of death in young adulthood. Apart from the direct effects on patients' lives, TBI causes serious socio-economic consequences. Furthermore, clinicians as well as relatives often have to face crucial treatment decisions.
Against this background the introduction of the Impact Prognostic Calculator (IPC) enabled a reliable predictability of mortality and unfavorable outcome and serves as a decision aid.
The aim of the prospective monocentric study is the specific validation of IPC in patients with moderate to severe TBI in comparison to a former retrospective study.
Methods: The study encompassed a total of 160 patients in the age from 18 to 99 years suffering TBI treated in the intensive care unit in a German Level 1 Trauma Center during the investigation period from January to September 2017. The classification of the severity level into mild, moderate and severe was based on GCS.
The documentation of different relevant parameters such as motor score, pupil reaction or CT classification was performed at defined times early after TBI. Data analysis was performed using Core, Core + CT and Core + CT + Lab-model.
Results: Of the 160 patients included, 104 belong to the group of GCS 13 – 15. Another 19 patients had a moderate TBI (GCS 9 -12) and 37 patients suffered a severe TBI with a GCS of 3 – 8. For patients who suffer from mild TBI, a reliable statement can be given within the first six hours after injury. In cases of severe TBI, the most reliable statements against the background of mortality and unfavorable outcome are possible 48 to 72 hours after trauma. In total, the results ofthe former retrospective study are confirmed, except for small differences.
Conclusion: The findings of this prospective study enable a valid estimation of short and long term outcome after severe TBI by means of IPC. In addition to the usefulness in the decision making process, the IPC is a useful guidance for concerned dependants.
In future, the available data may help to establish a specially tailored supply concept for patients suffering from TBI in our Trauma Center.
