THE CONTRIBUTION OF EXTRACRANIAL COMPLICATIONS TO THE OUTCOME OF INTENSIVE CARE IN PATIENTS WITH SEVERE TRAUMATIC BRAIN INJURY

Abstract

Not only the damage to the brain matter itself as a result of injury, but also secondary damaging factors affect the outcome of TBI.
The purpose of this study is to analyze the structure of extracranial complications occurring in patients with severe TBI and to assess the impact of these complications on mortality.
Materials and methods. An observational retrospective cohort study included 110 adult patients with severe isolated TBI (baseline level of consciousness on the Glasgow Coma scale (SHG) <9 points). The average age was 34±7 years, 76 of them were men. The average length of stay in the intensive care unit (ICU) was 15± 6 days.
The results. In the present study, it was found that extracranial complications were frequent during ICU stay in a cohort of patients with severe TBI. Hypoxia and hypotension were most often observed when patients with PMT were admitted. Thus, hypoxia at admission was found in 67 patients, and arterial hypotension at admission to the ICU was found in 39 patients. We found that hypotension, pneumonia, infectious complications and coagulation dysfunction were associated with unfavorable results, along with indicators of TBI severity (low initial GSC score, worse data on initial CTG and intracranial hypertension) independently contributed to an increase in hospital mortality (p< 0.05).
Conclusions. Extracranial complications increase both the length of stay and morbidity in the ICU, as well as mortality in patients with severe traumatic brain injury. Severe respiratory insufficiency and low GSC values on the background of hypotension are independently associated with mortality in the ICU.