Predicting outcome from closed head injury by early assessment of trauma severity: Williams JM, Gomes F, Drudge OW, et al J Neurosurg 61:581–585 Sep 1984
✍ Scribed by Richard P Burruss
- Publisher
- Elsevier Science
- Year
- 1985
- Tongue
- English
- Weight
- 107 KB
- Volume
- 14
- Category
- Article
- ISSN
- 1097-6760
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✦ Synopsis
There have been many attempts to predict outcome of severe head injury using such measures as oculovestibular deficit, hemiparesis, pupil abnormalities, skull fracture, hematoma, length of coma, elevations of intracranial pressure, and patient age. The authors investigated the relationship of early measures of trauma severity in the emergency department lie, level of coma, presence of pupil abnormality, acute hemiparesis, skull fracture, and evidence of mass lesion) to global outcome using stepwise regression analysis. They also looked at how estimates of premorbid IQ predicted outcome. Most of the injuries (66%) were due to motor vehicle accidents. In their sample of 96 patients, there were 25 cases of mass lesion , 28 cases of skull fracture, 25 cases with hemiparesis, and 21 cases with pupil abnormality. The authors found that coma grading using the Glasgow coma scale done in the emergency department was the best predictor of general cognitive functioning after the injury. They also concluded that estimates of premorbid IQ were important in predicting outcome, but that presence of mass lesion, pupil abnormality, and skull fracture provided largely redundant information.