Traumatic brain injury (TBI) outcomes in an LMIC tertiary care centre and performance of trauma scores.
<h4>Background</h4> <p>This study evaluates post-ICU outcoes of patients admitted with moderate and severe Traumatic Brain Injury (TBI) in a tertiary neurocritical care unit in an low middle income country and the performance of trauma scores: A Severity Characterization of Trauma...
| Hoofdauteurs: | , , , , , , , , |
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| Formaat: | Journal article |
| Taal: | English |
| Gepubliceerd in: |
BioMed Central
2018
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| _version_ | 1826302748347334656 |
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| author | Samanamalee, S Sigera, P De Silva, A Thilakasiri, K Rashan, A Wadanambi, S Jayasinghe, K Dondorp, A Haniffa, R |
| author_facet | Samanamalee, S Sigera, P De Silva, A Thilakasiri, K Rashan, A Wadanambi, S Jayasinghe, K Dondorp, A Haniffa, R |
| author_sort | Samanamalee, S |
| collection | OXFORD |
| description | <h4>Background</h4> <p>This study evaluates post-ICU outcoes of patients admitted with moderate and severe Traumatic Brain Injury (TBI) in a tertiary neurocritical care unit in an low middle income country and the performance of trauma scores: A Severity Characterization of Trauma, Trauma and Injury Severity Score, Injury Severity Score and Revised Trauma Score in this setting.</p> <h4>Methods</h4> <p>Adult patients directly admitted to the neurosurgical intensive care units of the National Hospital of Sri Lanka between 21st July 2014 and 1st October 2014 with moderate or severe TBI were recruited. A telephone administered questionnaire based on the Glasgow Outcome Scale Extended (GOSE) was used to assess functional outcome of patients at 3 and 6 months after injury. The economic impact of the injury was assessed before injury, and at 3 and 6 months after injury.</p> <h4>Results</h4> <p>One hundred and one patients were included in the study. Survival at ICU discharge, 3 and 6 months after injury was 68.3%, 49.5% and 45.5% respectively. Of the survivors at 3 months after injury, 43 (86%) were living at home. Only 19 (38%) patients had a good recovery (as defined by GOSE 7 and 8). Three months and six months after injury, respectively 25 (50%) and 14 (30.4%) patients had become “economically dependent”. Selected trauma scores had poor discriminatory ability in predicting mortality.</p> <h4>Conclusions</h4> <p>This observational study of patients sustaining moderate or severe TBI in Sri Lanka (a LMIC) reveals only 46% of patients were alive at 6 months after ICU discharge and only 20% overall attained a good (GOSE 7 or 8) recovery. The social and economic consequences of TBI were long lasting in this setting. Injury Severity Score, Revised Trauma Score, A Severity Characterization of Trauma and Trauma and Injury Severity Score, all performed poorly in predicting mortality in this setting and illustrate the need for setting adapted tools.</p> |
| first_indexed | 2024-03-07T05:52:14Z |
| format | Journal article |
| id | oxford-uuid:e94869d6-9e02-4f59-85a6-b4873b8ccad8 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T05:52:14Z |
| publishDate | 2018 |
| publisher | BioMed Central |
| record_format | dspace |
| spelling | oxford-uuid:e94869d6-9e02-4f59-85a6-b4873b8ccad82022-03-27T10:53:12ZTraumatic brain injury (TBI) outcomes in an LMIC tertiary care centre and performance of trauma scores.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:e94869d6-9e02-4f59-85a6-b4873b8ccad8EnglishSymplectic Elements at OxfordBioMed Central2018Samanamalee, SSigera, PDe Silva, AThilakasiri, KRashan, AWadanambi, SJayasinghe, KDondorp, AHaniffa, R <h4>Background</h4> <p>This study evaluates post-ICU outcoes of patients admitted with moderate and severe Traumatic Brain Injury (TBI) in a tertiary neurocritical care unit in an low middle income country and the performance of trauma scores: A Severity Characterization of Trauma, Trauma and Injury Severity Score, Injury Severity Score and Revised Trauma Score in this setting.</p> <h4>Methods</h4> <p>Adult patients directly admitted to the neurosurgical intensive care units of the National Hospital of Sri Lanka between 21st July 2014 and 1st October 2014 with moderate or severe TBI were recruited. A telephone administered questionnaire based on the Glasgow Outcome Scale Extended (GOSE) was used to assess functional outcome of patients at 3 and 6 months after injury. The economic impact of the injury was assessed before injury, and at 3 and 6 months after injury.</p> <h4>Results</h4> <p>One hundred and one patients were included in the study. Survival at ICU discharge, 3 and 6 months after injury was 68.3%, 49.5% and 45.5% respectively. Of the survivors at 3 months after injury, 43 (86%) were living at home. Only 19 (38%) patients had a good recovery (as defined by GOSE 7 and 8). Three months and six months after injury, respectively 25 (50%) and 14 (30.4%) patients had become “economically dependent”. Selected trauma scores had poor discriminatory ability in predicting mortality.</p> <h4>Conclusions</h4> <p>This observational study of patients sustaining moderate or severe TBI in Sri Lanka (a LMIC) reveals only 46% of patients were alive at 6 months after ICU discharge and only 20% overall attained a good (GOSE 7 or 8) recovery. The social and economic consequences of TBI were long lasting in this setting. Injury Severity Score, Revised Trauma Score, A Severity Characterization of Trauma and Trauma and Injury Severity Score, all performed poorly in predicting mortality in this setting and illustrate the need for setting adapted tools.</p> |
| spellingShingle | Samanamalee, S Sigera, P De Silva, A Thilakasiri, K Rashan, A Wadanambi, S Jayasinghe, K Dondorp, A Haniffa, R Traumatic brain injury (TBI) outcomes in an LMIC tertiary care centre and performance of trauma scores. |
| title | Traumatic brain injury (TBI) outcomes in an LMIC tertiary care centre and performance of trauma scores. |
| title_full | Traumatic brain injury (TBI) outcomes in an LMIC tertiary care centre and performance of trauma scores. |
| title_fullStr | Traumatic brain injury (TBI) outcomes in an LMIC tertiary care centre and performance of trauma scores. |
| title_full_unstemmed | Traumatic brain injury (TBI) outcomes in an LMIC tertiary care centre and performance of trauma scores. |
| title_short | Traumatic brain injury (TBI) outcomes in an LMIC tertiary care centre and performance of trauma scores. |
| title_sort | traumatic brain injury tbi outcomes in an lmic tertiary care centre and performance of trauma scores |
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