Risk factors for unfavorable outcome in surgical treatment of acute head injury
https://doi.org/10.17650/1683-3295-2013-0-2-8-16
Abstract
The objective of this study was to determine the risk factors for unfavorable treatment outcome at surgically treated patients with acute head injury. This study was based on the examination (изучение) of clinical signs and instrumental examination data as well as surgical treatment outcomes of 1098 patient s with acute head injury (time from trauma till operation was not more than 72 hours). We divided all risk factors for unfavorable treatment outcomes into three groups based on data of conducted analysis. First group included high-degree risk factors, second group - moderate-degree risk factors and third group - low-degree risk factors. The high-degree risk factors for unfavorable treatment outcome were clinical signs and CT-signs of acute dislocation syndrome. The moderate-degree risk factors were follows: acute subdural hematoma or multiple brain damages according to CT data, the volume of brain damage focus more than 100 cm3, lateral brain dislocation more than 10 mm, subarachnoid or ventricular hemorrhage, value of VCC-2 8% and less, presence of severe concomitant (сочетанных) extracranial damages (40 and more scores according to ISS) as well as secondary factors for ischemic brain injuries (arterial hypotension and hypoxemia). The low-degree risk factors were age of patients 60 years old and more and «malignant» untreatable intracranial hypertension during operation or in the early postoperative period. We reviewed in details each of determined risk factors with estimation of its statistical significance for influence on treatment outcome taking into account its duration and intensity of its action.
About the Authors
Ju. V. Puras
НИИ скорой помощи им. Н.В. Склифосовского
Russian Federation
Russian Federation
A. E. Talypov
НИИ скорой помощи им. Н.В. Склифосовского
Russian Federation
Russian Federation
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Review
For citations:
Puras J.V., Talypov A.E. Risk factors for unfavorable outcome in surgical treatment of acute head injury. Russian journal of neurosurgery. 2013;(2):8-16. (In Russ.) https://doi.org/10.17650/1683-3295-2013-0-2-8-16
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