ปัจจัยที่มีความสัมพันธ์กับผลลัพธ์ทางคลินิกภายหลังผ่าตัดในผู้ป่วยบาดเจ็บที่สมองที่เข้ารับ การรักษาในโรงพยาบาลกระบี่

Chatchai   Srisun

Authors

Chatchai Srisun Krabi Hospital

Keywords:

Clinical outcomes, postoperative complications, traumatic brain injury

Abstract

Background: Traumatic brain injury represents a critical public health issue, contributing to mortality, disability, reduced quality of life, and substantial healthcare costs. Despite surgical intervention, a considerable proportion of patients continue to experience complications and variable clinical outcomes. Understanding the factors influencing these outcomes is therefore essential for the development of more effective management strategies.

Objective: To examine the factors associated with postoperative clinical outcomes in patients with traumatic brain injury treated at Krabi Hospital.

Material and methods: This study employed a retrospective cohort design. Data was collected from the medical records of patients treated at Krabi Hospital. The sample consisted of 308 medical records of patients with traumatic brain injury who underwent surgical treatment between 2020 and 2024. Data collection instruments included (1) a form for recording personal and health status and (2) a form for recording injury and treatment-related data. Personal and clinical data were analyzed using descriptive statistics, including frequency, percentage, mean, and standard deviation, as well as t-tests, while Spearman’s correlation was employed to examine associations between variables.

Result: The study findings indicated that several factors were significantly associated with post-surgical outcomes in patients with traumatic brain injury. Initial level of consciousness upon hospital admission (rₛ = -0.666), time from hospital arrival to surgery (rₛ = -0.605), midline shift of the brain (rₛ = -0.564), hypotension (rₛ = -0.597), pupil size and reactivity (rₛ = -0.637), type of surgical intervention (rₛ = -0.546), and postoperative complications (rₛ = -0.622) all demonstrated strong negative correlations with outcomes, with statistical significance at p < .001.

Conclusion: Significant factors associated with clinical outcomes following surgery in patients with traumatic brain injury include level of consciousness, time to treatment, severity of neurological symptoms, surgical factors, and postoperative complications. Notably, variables reflecting injury severity and timeliness of care play critical roles in determining patient outcomes.

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