Severe traumatic brain injury: consequences of early adverse events

Acta Anaesthesiol Scand. 2011 Sep;55(8):944-51. doi: 10.1111/j.1399-6576.2011.02451.x. Epub 2011 May 16.

Abstract

Background: Several factors associated with an unfavourable outcome after severe traumatic brain injury (TBI) have been described: prolonged pre-hospital time, secondary referral to a level 1 trauma centre, the occurrence of secondary insults such as hypoxia, hypotension or low end-tidal carbon dioxide (ETCO(2)). To determine whether adverse events were linked to outcome, patients with severe TBI were studied before arrival at a level 1 trauma centre.

Methods: Prospective, observational study design. Patients with severe TBI (n = 48), admitted to Umeå University Hospital between January 2002 to December 2005 were included. All medical records from the site of the accident to arrival at the level 1 trauma centre were collected and evaluated.

Results: A pre-hospital time of >60 min, secondary referral to a level 1 trauma centre, documented hypoxia (oxygen saturation <95%), hypotension (systolic blood pressure <90 mmHg), hyperventilation (ETCO(2) <4.5 kPa) or tachycardia (heart rate >100 beats/min) at any time before arrival at a level 1 trauma centre were not significantly related to an unfavourable outcome (Glasgow Outcome Scale 1-3).

Conclusion: Early adverse events before arrival at a level 1 trauma centre were without significance for outcome after severe TBI in the trauma system studied.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Accidents
  • Adolescent
  • Adult
  • Aged
  • Blood Pressure / physiology
  • Brain Injuries / complications*
  • Brain Injuries / mortality
  • Brain Injuries / physiopathology
  • Carbon Dioxide / blood
  • Critical Care
  • Female
  • Glasgow Coma Scale
  • Glasgow Outcome Scale
  • Heart Rate / physiology
  • Humans
  • Injury Severity Score
  • Male
  • Middle Aged
  • Multiple Trauma / therapy
  • Oxygen / blood
  • Prognosis
  • Prospective Studies
  • Transportation of Patients
  • Trauma Centers / statistics & numerical data
  • Treatment Outcome
  • Young Adult

Substances

  • Carbon Dioxide
  • Oxygen