Citation

Tanaka C, Tagami T, Unemoto K, Kudo S, Takehara A, Kaneko J, Yokota H. Brain Inj. 2019; 33(7): 869-874.

Affiliation

Department of Emergency and Critical Care Medicine , Nippon Medical School , Tokyo , Japan.

Copyright

(Copyright © 2019, Informa - Taylor and Francis Group)

DOI

10.1080/02699052.2019.1614667

PMID

31084363

Abstract

PURPOSE: Among mild traumatic brain injuries (mTBI; a Glasgow Coma Scale score ≥13 on arrival), few result in severe neurological deficit, especially when they needed neurosurgical intervention. We investigated the association of intracranial pressure (ICP) control management with neurological outcome in patients with mTBI who needed neurosurgical intervention.

METHODS: From 1,092 records of the Japan Neurotrauma Data Bank during 2009-2011, we retrospectively identified 195 patients with neurosurgical intervention for mTBI. Using the Glasgow Outcome Scale, we grouped records into two: favorable and poor outcome. We analyzed neurological outcomes using a logistic regression analysis adjusted for ICP control managements.

RESULTS: Seventy patients had a poor outcome. Logistic regression analysis revealed that sedatives, hyperosmotic agents, and hyperventilation therapy were significantly associated with poor outcome (odds ratio [OR]: 2.36, 95% confidence interval [CI]: 1.31-4.26; OR: 2.81, 95% CI: 1.17-6.75; OR: 9.36, 95% CI: 1.81-48.35). However, temperature management was significantly related with favorable outcome (OR: 0.26, 95% CI: 0.10-0.66).

CONCLUSIONS: Our study, using a Japanese multicenter brain trauma registry, suggested that requirement of sedatives, hyperosmotic agents, and hyperventilation is associated with poor neurological outcome for patients with mTBI who underwent neurosurgical intervention, although temperature management was associated with favorable neurological outcome.

Language: en

Keywords

Mild traumatic brain injury; intracranial pressure control therapy; neurological outcome; neurosurgical operation