Evaluation of Midline Shift and GCS as an Outcome in Severe Traumatic Brain Injury

Authors

  • SYED SHAHZAD HUSSAIN Department of Neurosurgery, Jinnah Hospital, Lahore
  • USMAN AHMAD KAMBOH Department of Neurosurgery, Jinnah Hospital, Lahore
  • MUHAMMAD ASIF RAZA Department of Neurosurgery, Jinnah Hospital, Lahore
  • SAMAN SHAHID Department of Sciences & Humanities, National University of Computer & Emerging Sciences (NUCES), Lahore
  • NAVEED ASHRAF Department of Neurosurgery, Jinnah Hospital, Lahore

Keywords:

Severe Traumatic Brain Injury, Motor Response, Mortality

Abstract

Objectives: We determined the frequency of mortality in patients with traumatic brain injury and to compare frequency of midline shift and poor motor response in traumatic brain injury patients with and without mortality.
Materials & Methods: Total 108 patients with severe TBI aged between 18 to 60 years were included. Admission GCS and motor response of post-nonsurgical resuscitation were recorded, along with midline shift on initial CT-scan. All patients were followed for the mortality up to 2 weeks. Chi square test applied for the frequency comparisons of ‘midline shift’ and ‘poor motor response’.
Results: Mean age was 38.88 ± 8.94 years. Out of the 108 patients, 68 (62.96%) were males and 40 (37.04%) were females. Mean admission GCS was 3.39 ± 1.87. Mean motor response was 3.12 ± 1.68. Mean midline shift was 7.37 ± 2.09 mm. Mortality was found in 66 (61.11%) patients, whereas, there was no mortality in 42 (38.89%) patients. High mortality percentage (60%) was found in age group: 20-30 years. In male patients, high mortality percentage was found (63.24%) as compared to female patients. Comparable differences were found in the frequencies of ‘midline shifts’ and ‘poor motor response’ in patients with mortality.
Conclusion: The frequency of mortality in patients with severe TBI was found high. The ‘motor scores’ and ‘midline shifts’ can predict the outcome of severe TBI, because, comparable differences were found in the frequencies of ‘midline shifts’ and ‘poor motor response’.

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2019-06-04

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