Articles: brain-injuries.
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Multicenter Study
Determinants of hospital costs associated with traumatic brain injury in England and Wales.
Using data from the Trauma Audit Research Network, we investigated the costs of acute care in patients > or = 18 years of age hospitalised for traumatic brain injury between January 2000 and December 2005 in England and Wales. Traumatic brain injury patients were defined and stratified using the Abbreviated Injury Scale. A total of 6484 traumatic brain injury patients were identified; 22.3% had an Abbreviated Injury Scale score of three, 38.0% of four and 39.7% of five. ⋯ In total 23.7% of the patients died before discharge. Hospitalisation costs averaged 15,462 pounds sterling (SD 16,844 pounds sterling). Costs varied significantly by age, Glasgow Coma Score, Injury Severity Score, coexisting injuries of the thorax, spine and lower limb, hospital mortality, availability of neurosurgical services, and specialty of attendants seen in the Accident and Emergency department.
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Intensive care medicine · Apr 2008
Multicenter StudyExtracranial complications in patients with acute brain injury: a post-hoc analysis of the SOAP study.
To assess the incidence and severity of nonneurological organ dysfunction and its effect on outcome in acute neurological patients in an international cohort observational study. ⋯ Although neurological patients were younger and had fewer comorbidities, they developed ICU-acquired sepsis and respiratory failure more frequently than other patients. Efforts should be oriented to reduce cardiovascular, hepatic, and respiratory complications.
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Multicenter Study
Predicting outcome after traumatic brain injury: practical prognostic models based on large cohort of international patients.
To develop and validate practical prognostic models for death at 14 days and for death or severe disability six months after traumatic brain injury. ⋯ Simple prognostic models can be used to obtain valid predictions of relevant outcomes in patients with traumatic brain injury.
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Multicenter Study Comparative Study
Assessing the level of consciousness in children: a plea for the Glasgow Coma Motor subscore.
The Glasgow Coma Scale (GCS) is not always easy to score and its reliability has been questioned. In adults the GCS Motor score has proven a valuable alternative, as it is easier to assess yet shows similar predictive capacity for outcome. We wanted to test the non-inferiority of the Glasgow Coma Motor score GCS-M versus the Total score GCS-T for predicting outcome in children. ⋯ The GCS Motor subscore was shown to have at least the same predictive ability for outcome as the total GCS. It is our opinion that the total GCS is unnecessarily complicated (especially in children). Using the Motor score alone will improve scoring compliance and statistical performance. We do not believe that the reduction in number of potential scores from 13 to 6 would decrease the descriptive capacity significantly, since clinical algorithms typically group values of the total GCS into five or fewer ranges.
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Multicenter Study
Aggressive red blood cell transfusion: no association with improved outcomes for victims of isolated traumatic brain injury.
Clinical studies have caused blood transfusion practices in critically ill patients to become more conservative in the last decade. However, few studies have focused on trauma patients, particularly those with severe isolated traumatic brain injury. ⋯ Our results suggest that a restrictive transfusion practice is safe for severely head-injured patients.