Predictors of long-term outcome in severe head injury.
Severe head injury is associated with significant morbidity and mortality. We conducted a retrospective study to assess the long-term outcome of these patients using the Glasgow Outcome Score (GOS) and evaluate the variables that might predict outcome. Data were collected from all post-traumatic neurosurgical patients with severe head injury (Glasgow Coma Scale 8 or less) admitted to the Surgical Intensive Care Unit over a 29-month period. The long-term outcome was assessed one year after the injury by a telephone interview or a review of the hospital records. Seventy patients satisfied the criteria for the study. The male to female ratio was 9:1. The mean age of the patients was 37 (range 17 to 84) years. The overall mortality was 50%. Patients with a poor outcome (defined as GOS scores of 1 to 3) had a significantly higher mean age, higher Acute Physiology and Chronic Health Evaluation (APACHE) II score and a lower Glasgow Coma Scale than those with a good outcome (GOS 4 to 5). The APACHE II score correlated better with outcome than the Glasgow Coma Scale or age. The APACHE II score may be used to prognosticate the long-term outcome in severe head injury.
Lai
Y C
YC
Department of Anaesthesiology, Tan Tock Seng Hospital, Singapore.
Chen
F G
FG
Goh
M H
MH
Koh
K F
KF
D018806:APACHE; D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D006259:Craniocerebral Trauma / Q000145:classification* / Q000401:mortality / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D015600:Glasgow Coma Scale; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012846:Singapore; D015996:Survival Rate