Factors Predicting Mortality in the Patients with Moderate to Severe Traumatic Brain Injury

Abstract

This retrospective study aimed to explore the incidence of mortality and factors predicting mortality in patients with moderate to severe traumatic brain injury (TBI) after hospital admission. The participants were recruited with a purposive sampling method. The 270 participants were systematically randomized from the lists of patients’ medical records. Data were collected from the medical records of patients with traumatic brain injury who were admitted between 1 January 2020 and 31 December 2020. The instrument used to collect data was a predicting mortality factors form developed by the researchers. The data were analyzed using descriptive statistics and multiple logistic regression analysis. The results of the study showed that the incidence rate of mortality in patients with moderate to severe traumatic brain injury was 28.9%. Most of them were male (25.9%), aged between 18 to 30 years old, had traffic accidents (20.4%), fell from a height or fell down (12.2%), and assault (1.5%). Predictive factors for brain injury mortality in traumatic brain injury patients included the first assessment of Glasgow Coma Scale (GCS) of 3-8 (OR_Adj=2.44; 95%CI :1.10–5.40), Subarachnoid hemorrhage (OR_Adj=2.06 ; 95%CI: 1.09 – 3.88), Brain edema (OR_Adj=3.67 ; 95%CI:1.50–8.99), Brain Herniation (OR_Adj=3.31 ; 95%CI: 1.58–6.94 ), and Mydriasis (OR_Adj=.36 ; 95%CI: .15–.83) This study suggested that nurses should develop a nursing intervention model for patients with moderate to severe traumatic brain injury within 72 hours after diagnoses and provide treatment immediately, especially patients with a low GCS score, a CT scan showing mydriasis, subarachnoid hemorrhage, brain edema and brain herniation. These are signs of severe pathology that increase incidence of mortality.