Document Detail


Which CT features help predict outcome after head injury?
MedLine Citation:
PMID:  11796768     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Information collected at baseline can be useful in predicting patient outcome after head injury. The appearance of the CT brain scan may add useful baseline information. The aim of this study was to evaluate which features on the admission CT scan might add significantly to other baseline clinical information for predicting survival in patients with head injury. METHODS: Baseline CT scans were reviewed for patients with all grades of traumatic head injury in a head injury registry, in which baseline demographic and injury status and outcome at 1 year were recorded. Details from the CT scan on haemorrhage, brain swelling, and focal or diffuse damage were noted blind to clinical or outcome information and the scans classified according to the simple seven point grading (normal, mild, moderate, or severe focal injury, mild, moderate, or severe diffuse injury). An existing CT scoring system, the trauma coma databank (TCDB) classification, was also used. Logistic regression modelling was used to test the value of the CT appearance, in addition to the other baseline clinical characteristics, in predicting survival at 1 year. RESULTS: 425 CT scans were read from patients with all severities of injury. Significant independent outcome predictors were age, Glasgow coma score (GCS), pupil reaction, presence of subarachnoid blood, and the simple grading of the overall appearance of the scan (all p<0.001). The TCDB classification was not a significant predictor of outcome. CONCLUSION: Age, GCS, and pupil reaction were all previously shown to be significant predictors of patient survival after head injury. A further two, easy to identify, CT scan variables are independent prognostic variables, and might help to identify patients at high risk of death at the time of admission.
Authors:
J M Wardlaw; V J Easton; P Statham
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of neurology, neurosurgery, and psychiatry     Volume:  72     ISSN:  0022-3050     ISO Abbreviation:  J. Neurol. Neurosurg. Psychiatr.     Publication Date:  2002 Feb 
Date Detail:
Created Date:  2002-01-17     Completed Date:  2002-02-27     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  2985191R     Medline TA:  J Neurol Neurosurg Psychiatry     Country:  England    
Other Details:
Languages:  eng     Pagination:  188-92; discussion 151     Citation Subset:  IM    
Affiliation:
Department of Clinical Neurosciences, Western General Hospital, Edinburgh, UK. jmw@skull.dcn.ed.ac.uk
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MeSH Terms
Descriptor/Qualifier:
Brain Damage, Chronic / mortality,  radiography*
Brain Edema / mortality,  radiography*
Cerebral Hemorrhage / mortality,  radiography*
Diffuse Axonal Injury / mortality,  radiography*
Female
Follow-Up Studies
Glasgow Coma Scale
Humans
Male
Prognosis
Retrospective Studies
Subarachnoid Hemorrhage / mortality,  radiography
Survival Rate
Tomography, X-Ray Computed*
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