Clinical characteristics of patients with severe brain injury within 6 months

Ref: Vedantam A, et alJNeurosurg2018 Jul;129 (1): 234-240doi: 10.3171/2017.3.JNS162720Epub 2017 Sep 22.)some patients with severe brain injury (TBI) who can end life-support therapy early due to poor expected efficacyTherefore, it is important to establish conditions and timing for discontinuation of treatmentAditya Vedantam of the University of Texas School of Neurology in Washington, Texas, usa, studied early neurofunction recovery in patients with a good prognosis of severe brain trauma to address this problemThe results were published in the July 2018 issue of J Neurosurgreviewed clinical data on 1,241 cases of brain injury received between 1986 and 2012A sample of 218 patients with a sports Glasgow coma scale (mGCS) score of less than 6 points and a GOS score of 4 or 5, moderate disability or a good recovery were included in the studyAt the same time, the patient demographic, clinical and imaging data are analyzedDetailed record of the time when the mGCS score was reached for the first time from injury to injury was 6 points, and the GOS score follow-up record was assessed from discharge to 6 months after injuryof the 218 cases in, 183 were for men and 35 in women, with an average age of 28.9 to 11.2 years71.4% of patients had a follow-up action in the first week after injury, with an mGCS score of 6, of which 28.6% performed on the first day after the injury (Figure 1) 14.8% of patients after injury to recovery have the time of follow-up action is more than 2 weeks, the intracranial pressure monitoring time of this type of patient shorter (p.001), the use of neuromuscular blocking drugs also extended time (p 0.001) Compared with patients with moderate disabilities, patients with good recovery had a higher initial GCS score (p.01), a lower incidence of pupil reduction during admission (p.048), a shorter hospital stay in the ICU (p.001), and a shorter total length of hospitalization (p.001) And from discharge to 6 months of follow-up, goS scores improved significantly Figure 1 Percentage of mGCS 6 patients at different times after severe brain trauma concluded that 15% of heavy-duty TBI patients may have a good prognosis, and that follow-up within 2 weeks of injury indicates that even if motor function is slow to recover, better outcomes can be obtained Heavy-duty TBI patients with better prognosis during hospitalization had a significant improvement in GOS scores for 6 months from discharge to follow-up, and therefore, early life-stopping support was not recommended for patients with heavy TBI (The first hospital affiliated with Fujian Medical University
Cai Hanpei compiled, Fudan University affiliated Huashan Hospital Professor Wang Zhiqiu review, "Outside the Information" editor-in-chief, Fudan University affiliated Huashan Hospital Chen Jicheng Professor Final Appeal) related links