title: [Evaluation of treatment outcome in patients after extremely severe head injury (GCS 3-4)].
abstract: Advances in the diagnosis and treatment of severe head injured patients (GCS < = 8) have led to major improvement in outcome, but have not eliminated high mortality rates, which range between 38 and 80% as reported in the literature. The aim of this study was to evaluate the outcome of patients with GCS 3 and 4 and to evaluate the role of early and late hypotension (systolic blood pressure SBP < 90 mmHg) in outcome. Sixty two patients with severe head injury were divided into two groups. In Group I-22 patients with GCS 3-4, and in Group II-40 patients with GCS 5-8. There was no significant difference between mortality (p = 0.5), poor outcome (p = 0.36), and the very best outcome in the groups (p = 0.06). There was a statistically significant difference in death rate (p = 0.0012), when hypotension was present at the scene. Our data suggest that patients with extremely severe head injury do not necessarily have a worse outcome, if prompt diagnosis and appropriate aggressive treatment is implemented.
authors.affiliation: Oddziału Neurochirurgii, Szpitala Westmead, Sydney, Australia.
authors.forename: R
authors.initials: R
authors.lastname: Abraszko
authors.forename: Y
authors.initials: Y
authors.lastname: Zurynski
authors.forename: N
authors.initials: N
authors.lastname: Dorsch
authors.forename: Y
authors.initials: Y
authors.lastname: Mudaliar
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D006259:Craniocerebral Trauma / Q000150:complications / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D007022:Hypotension / Q000150:complications; D008297:Male; D008875:Middle Aged; D015996:Survival Rate; D016896:Treatment Outcome
vernacular_title: Ocena wyników leczenia pacjentów ze szczególnie ciezkimi urazami czaszkowo-mózgowymi (GCS 3-4).