Functional outcome at 6 months of surgical traumatic brain injury: A single Caribbean Center pilot study

Background. This is the first prospective study that evaluates the functional outcome after a surgical procedure secondary to a traumatic brain injury, in a single center, in Dominican Republic.

Aim. To determine the functional status of surgically treated patients 6 months post-trauma, the relative risk of poor prognosis and association of functional status with the predictive variables of the International Mission for Prognosis and Analysis of Clinical Trials in traumatic brain injury.

Materials and methods. A prospective, longitudinal study was conducted in a cohort of 22 patients surgically treated for a traumatic intracranial injury at Dr. Ney Arias Lora Traumatology Hospital in Dominican Republic. We applied the International Mission for Prognosis and Analysis of Clinical Trials calculator, (pupillary response, hemoglobin, hypoxia, age, motor response, computed tomography lesion, hypotension, etc.) prior to surgery and the Extended Glasgow Outcome Scale 6 month after surgery to determine the functional outcome. The International Mission for Prognosis and Analysis of Clinical Trials form was modified by adding preoperative glucocorticosteroids and rehabilitation therapy. The SPSS database (15.0 version, Chicago Il.) was used. Central tendency measures and Fisher's test were applied. Thus, p ≤0.05 with a 95 % confidence interval was considered statistically significant.

Results. The predictive variables associated with a poor prognosis were motor response (p = 0.01), hypoxia and hypotension (p = 0.05). Alterations in motor response was associated with increased morbidity and mortality (RR: 10; 95 % CI: 3-22). Normal flexion was found in all patients with good recovery (p = 0.04).

Conclusion. As a result, 67 % of patients had a good functional result (moderate disability and good recovery). Mortality was 23 %. Preoperative motor response is a powerful prognostic factor in traumatic brain injury.

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