The importance of immune system disorders related to the Glasgow Outcome Score in patients after severe brain injury.
BACKGROUND
It is assumed that changes in different parts of the host defence mechanisms could influence the outcome by making way for extracranial complications.


METHODS
For our study we enrolled 121 patients who had sustained various types of severe head injury (GCS 3-8). We investigated several laboratory parameters. Furthermore we observed all extracranial complications that occurred within first ten days of hospitalization. Six months after the discharge we assessed GOS and we put all these parameters in correlation.


RESULTS
55.37 % of the patients ended our treatment with an unfavourable outcome; mortality of the group was 40.5 %. We noted 117 cases of extracranial inflammatory complications, occurring in 94 patients (77.6 %). We confirmed a significant correlation between lower GCS and higher incidence of infection. Concerning the relationship between immune system disorders and outcome, we disclosed a significant difference, especially when comparing the group with good recovery with the patients who died. The difference was seen in cellular parameters, whereas humoral parameters showed no significant changes.


CONCLUSIONS
While GCS changes didn't relate to the intensity of immunity disorders, GOS value shows a strong relationship, especially to its cellular part. However, both GCS and GOS values showed an important correlation with the occurrence of infectious complications. Patients ending our treatment with bad outcome have more extracranial complications when compared with the patients that have ended our treatment successfully (Tab. 3, Fig. 6, Ref. 15). Full Text (Free, PDF) www.bmj.sk.
Mrlian
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Department of Neurosurgery, University Hospital, Brno, Czech Republic. andrejmrlian@hotmail.com
Smrcka
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Klabusay
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D001930:Brain Injuries / Q000276:immunology* / Q000401:mortality; D018791:CD4 Lymphocyte Count; D018414:CD8-Positive T-Lymphocytes; D003428:Cross Infection / Q000276:immunology; D023261:Glasgow Outcome Scale; D006801:Humans; D015996:Survival Rate