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KMID : 0359819960250030575
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Journal of Korean Neurosurgical Society
1996 Volume.25 No. 3 p.575 ~ p.583
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Prognostic Factors and Its Utility in Severe Head Injured Patient
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Abstract
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The prognosis of severe head injured patients (Glasgow Coma Scale 3 to 8) was assessed through clinical prognostic factors in 209 cases. retrospectively.
Severe head injured patients were 9.1% of all head trauma and 55% of cases were diffuse brain injury. Mechanism of injury were motorvehicle accident. falls. bicycle. and others.
The patients with normal pupillary reaction had a significantly higher percentage of good outcome (77%) than the patient with bilateral 3rd nerve palsy (14.2%) (p<0.0001) 79% of good motor responsive patients had a good outcome compared to none
of
patients with poor motor response (p<0.001). the patients with short duration of unawareness (within 30days) significantly higher percentage of good outcome (98%) than the patients with long duration of unawaereness (24%) (P<0.0001). The patients
with
initial high GCS score (6-8 score) had a significantly higher good outcome (58%) than the patients with low GCS score (3-5 score) (P<0.0001). 87% of pediatric patients had a good outcome compared to 38% of adults (p<0.0001). The diffuse head
injured
patients without basal cistern compression had a significantly nigher percentage of good outcome (83%) than the patients with basal cistern compression (41%) (p<0.0001) 62% of patients with skull fracture had a good outcome compared to 39% of
patients
without skull fracture (39%) (P<0.0017). Individual prognostic factors affect to patient's outcome and utilize to be powerful tool for assessing the relative efficacy of alternative treatments as well as patient's prognosis.
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