Risk factors associated with unfavorable outcome in patients with severe traumatic brain injury
Abstract
Traumatic brain injury (TBI) remains one of the leading causes of mortality and disability.
Objectives. To identify key risk factors for unfavorable outcome in patients with severe TBI.
Material and methods. The prospective study was conducted in the ICU (for neurosurgical patients) of the Minsk City Clinical Emergency Hospital from 2017 to 2024 years on the impact of potential risk factors on trauma outcomes. 116 patients with severe TBI were included in it.
Results. The age of patients with the unfavorable outcome was 50,00 [37,75; 60,00] and 38,00 [34,00; 56,00] years in case of the favorable outcome (p=0,0478). The volume of transfusion for 14 days in the ICU in patients with the unfavorable outcome was 2360,00 [1082,50; 4857,50] ml versus 1120,00 [50,00; 2280,00] ml in case of the favorable outcome (p=0,0006). While proving nutritional support the protein value of ≥1.5 g protein/kg/day was in 63,6% of patients with an unfavorable outcome compared to 38,4% with a favorable outcome (p=0, 0158). 80,2% of patients (n=93) had complications and only 63,8% of patients (n=74) had multiple complications (≥2). Pneumonia was present in 69,0% cases (n=74), pulmonary embolism – in 41,4% (n=48), MOF (multiple organ failure) – in 24,1% (n=28), meningitis and sepsis – in 12,1% of cases each (n=14).
Conclusions. The risk factors were identified: the age over 40 years (RR=1,53; p=0,0099), transfusion volume >2300 ml (RR=1.43; p=0,0099), protein part of nutrition support <1.5 g protein/kg/day (RR=1,42; p=0,0158) and presence of complications (RR=39,57; p=0,0086): pneumonia (RR=11,10; p<0,0001), pulmonary embolism (RR=2,22; p<0,0001), MOF (RR=1,70; p<0,0001), meningitis and sepsis (RR=1,48; p=0,0002).
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