FACTORS PREDICTING BRAIN INJURY SEVERITY IN THE PATIENTS WITH TRAUMATIC BRAIN INJURY

Abstract

           Objective : To study factors predicting brain injury severity in patients with moderate to severe traumatic brain injury (TBI) admitted to a provincial hospital. 

          Method : This correlational predictive study aimed to explore factors predicting brain severity in patients with moderate to severe traumatic brain injury. Previous studies showed that the factors predicting brain injury severity were gender, brain injury area, first assessed Glasgow Coma Score (GCS), abnormal findings from computerized tomography, decompressive craniectomy, hypoxia, hyperglycemia, hyperthermia, and hypothermia. The 285 samples were systematically randomized from the lists of moderate to severe TBI patients admitted within 72 hours in the trauma care unit of a tertiary hospital in Northeastern Thailand between 1 January 2020 and 31 December 2020. Data were collected from the medical records via the data-record form. The data were analyzed using descriptive statistics and multiple logistic regression analysis.

          Result : There were 285 samples, aged between 18 and 89 years old (mean=45.73; SD=19.70). Most of them were male (81.8%), had traffic accidents (63.90%), and fell from height or falling (30.50%). They were diagnosed as moderate brain injury (49.80%) and severe brain injury (50.20%). The results showed that the rate of brain injury severity was 24.90% (RTS score ≤ 4). Predicting factors of brain injury severity in traumatic brain injury patients were: first assessed Glasgow Coma Score (GCS) of 3-8 (ORAdj=39.77; 95%CI: 14.04-112.65; p<.001), intracerebral hemorrhage (ORAdj=3.38; 95%CI1.25-9.13:; p=.001), subarachnoid hemorrhage (ORAdj=2.94; 95%CI: 1.31-6.60; p<.0.01) and first assessed O2 saturation<90% (ORAdj =8.74; 95%CI : 1.32-57.64 ; p=0.02).

          Conclusion : Nurses can use the predictive factors to plan comprehensive care for patients with moderate to severe traumatic brain injury, considering the critical factors that require close supervision and monitoring for complications within 72 hours.