First CT findings and improvement in GOS and GOSE scores 6 and 12 months after severe traumatic brain injury

• Published in: Brain injury Vol. 23; no. 5; p. 403
• Main Authors: Corral, Luisa, Herrero, José Ignacio, Monfort, José Luis, Ventura, José Luis, Javierre, Casimiro F, Juncadella, Montserrat, García-Huete, Lucía, Bartolomé, Carlos, Gabarrós, Andreu
• Format: Journal Article
• Language: English
• Published: England 01.01.2009
• Subjects: Adult; Aged; Brain Injuries - diagnostic imaging; Brain Injuries - rehabilitation; Female; Glasgow Coma Scale; Glasgow Outcome Scale; Humans; Male; Middle Aged; Prognosis; Prospective Studies; Recovery of Function; Retrospective Studies; Time Factors; Tomography, X-Ray Computed; Treatment Outcome; Young Adult
• ISSN: 1362-301X
• DOI: 10.1080/02699050902788477

To analyse the association between individual initial computerized tomography (CT) scan characteristics and Glasgow Outcome Scale (GOS) and Extended Glasgow Outcome Scale (GOSE) improvement between 6 months and 1 year. Two hundred and twenty-four adult patients with severe traumatic brain injury and Glasgow Coma Scale (GCS) score of 8 or less who were admitted to an intensive care unit were studied. GOS and GOSE scores were obtained 6 and 12 months after injury in 203 subjects. Patients were predominantly male (84%) and median age was 35 years. Traumatic Coma Data Bank (TCDB) CT classification was associated with GOS/GOSE improvement between 6 months and 1 year, with diffuse injury type I, type II and evacuated mass improving more than diffuse injury type III, type IV and non-evacuated mass; for GOS 43/155 (28%) vs 3/48 (6%) (chi(2) = 9.66, p < 0.01) and for GOSE 71/155 (46%) vs 7/48 (15%) (chi(2) = 15.1, p < 0.01). CT individual abnormalities were not associated with GOS/GOSE improvement, with the exception of subarachnoid haemorrhage, which showed a negative association with GOSE improvement (chi(2) = 4.08, p < 0.05). TCDB CT scan classification and subarachnoid haemorrhage were associated with GOS/GOSE improvement from 6-12 months, but individual CT abnormalities were not associated.