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KMID : 0378119870140010292
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Chungnam Medical Journal
1987 Volume.14 No. 1 p.292 ~ p.304
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Clinical Study on Prognosis of Brain Damaged Patients
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Abstract
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This study was made to evaluate the difference in the prognosis between traumatic and non-traumatic brain damaged patients and based on a prospective study of 217 brain damaged patients admitted to ICU of Chungnam National University Hospital during recent 2 years with GCS less than 12 for at least 6 hours after attack.
The results were as following ;
1. 70.5% of 217 cases were traumatic and 29.5% were non-traumatic group.
2. Traumatic group showed the relatively even age and seasonal distribution and male predominancy. Majority of causes were traffic accident and fall. Focal lesions were more frequent than diffuse lesion and the most common focal lesion was acute epidural hematoma.
3. Non-traumatic brain damage occurred predominantly in the fourth and fifth decade and males outnumbered females by almost 2 to 1 and occurred frequently in spring and winter. Hypertensive intracerebral hematoma was the commonest lesion(over 50%).
4. The incidence of the associated injuries in traumatic group was about 35% and the site of associated injuries were distributed in face, limbs and chest in order. Chest, abdomen and multiple injuries were more frequent in the GCS group of 8 or less.
5. The incidence of skull fracture was about 71% and there was no significant difference in the type of fracture according to each GCS group.
6. Even though same age and GCS group, the mortality rate was higher in non-traumatic group than in traumatic group.
7. The mortality rate of the hypotensive patients in traumatic group and the hypertensive patients in non-traumatic group was significantly higher than of patients with nomal blood pressure in each group.
8. Even though same pupillary and motor response, the mortality rate was high in non-traumatic group than in traumatic group.
9. The mortality rate increased in proportion to the degree of midline shift on train CT but the patients without shift among non-traumatic group showed higher mortality rate than of the patients with mild or moderate shift.
10. Higher mortality rate was noted in the surgical cases of traumatic group and conservative cases of non-traumatic group.
11. The mortality related to complications was higher in non-traumatic group than in traumatic group.
12. Even though same GCS group, the prognos was different according to lesion type and the largest difference in distribution of mortality and good recovery rate between traumatic and non-traumatic group was noted in the GCS 6-8 group.
13. The mortality rate of non-traumatic group (59.4%) was higher than of traumatic group(47.1%) but the good recovery rate higher in traumatic group (33.3%) than of non-traumatic group. Even though same GCS group, non-traumatic group stowed high mortality rate than traumatic group.
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KEYWORD
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