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Remaining unconscious: The burden of traumatic brain injuries in India

INTRODUCTION: It is well-known that severe traumatic brain injuries (TBI) have a poor outcome. However, what is not well-known is the outcome for those who survive but remain unconscious at the time of discharge from the hospital. AIMS AND OBJECTIVES: To assess the outcome of severe TBI patients who...

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Autores principales: Agrawal, Deepak, Singh, P. K., Sinha, S., Gupta, D. K., Satyarthee, G. D., Misra, M. C.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4692009/
https://www.ncbi.nlm.nih.gov/pubmed/26752896
http://dx.doi.org/10.4103/0976-3147.165394
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author Agrawal, Deepak
Singh, P. K.
Sinha, S.
Gupta, D. K.
Satyarthee, G. D.
Misra, M. C.
author_facet Agrawal, Deepak
Singh, P. K.
Sinha, S.
Gupta, D. K.
Satyarthee, G. D.
Misra, M. C.
author_sort Agrawal, Deepak
collection PubMed
description INTRODUCTION: It is well-known that severe traumatic brain injuries (TBI) have a poor outcome. However, what is not well-known is the outcome for those who survive but remain unconscious at the time of discharge from the hospital. AIMS AND OBJECTIVES: To assess the outcome of severe TBI patients who have a motor response of M5 or lower on the Glasgow coma score (GCS) at discharge from a single centre in India. MATERIALS AND METHODS: In this retrospective study carried at one trauma centre in India, a prospectively maintained neurotrauma registry was queried from May 2010 to February 2013 for patients who had severe traumatic brain injury (GCS ≤ 8) at admission and had a motor response of M5 or lower on the GCS at discharge. Demographic and clinical data were analyzed, and outcome Glasgow outcome scale (GOS) assessed at 6 months using a telephonic questionnaire. OBSERVATIONS AND RESULTS: There were a total of 1525 patients with severe TBI in the study period. Of these 166 (10.9%) were unconscious (motor response M5 or lower on the GCS) at discharge from the hospital. 139 were males and 27 females with a mean age of 33.9 years. After a mean hospital stay of 24.31 days, the discharge motor score was M5 in 32 (19.3%), M4 in 44 (26.5%), M3 in 59 (35.5%), M2 in 44 (26.5%), and M1 in 9 (5.4%). Telephonic follow-up was available in 102 (61.4%) of the patients. 54 (52.9%) patients had died and 32 (31.4%) remained unconscious (vegetative) at 6 months. Only 16 patients (15.7%) had a good outcome (GOS 1–2) at 6 months following an injury. CONCLUSIONS: This is the only study of its kind on patients who remain unconscious at discharge following severe TBI and reveals that around 50% will die and another 30% remains vegetative at 6 months of discharge. Only a small percentage (15% in our study) will become conscious and partially integrated in the society.
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spelling pubmed-46920092016-01-08 Remaining unconscious: The burden of traumatic brain injuries in India Agrawal, Deepak Singh, P. K. Sinha, S. Gupta, D. K. Satyarthee, G. D. Misra, M. C. J Neurosci Rural Pract Original Article INTRODUCTION: It is well-known that severe traumatic brain injuries (TBI) have a poor outcome. However, what is not well-known is the outcome for those who survive but remain unconscious at the time of discharge from the hospital. AIMS AND OBJECTIVES: To assess the outcome of severe TBI patients who have a motor response of M5 or lower on the Glasgow coma score (GCS) at discharge from a single centre in India. MATERIALS AND METHODS: In this retrospective study carried at one trauma centre in India, a prospectively maintained neurotrauma registry was queried from May 2010 to February 2013 for patients who had severe traumatic brain injury (GCS ≤ 8) at admission and had a motor response of M5 or lower on the GCS at discharge. Demographic and clinical data were analyzed, and outcome Glasgow outcome scale (GOS) assessed at 6 months using a telephonic questionnaire. OBSERVATIONS AND RESULTS: There were a total of 1525 patients with severe TBI in the study period. Of these 166 (10.9%) were unconscious (motor response M5 or lower on the GCS) at discharge from the hospital. 139 were males and 27 females with a mean age of 33.9 years. After a mean hospital stay of 24.31 days, the discharge motor score was M5 in 32 (19.3%), M4 in 44 (26.5%), M3 in 59 (35.5%), M2 in 44 (26.5%), and M1 in 9 (5.4%). Telephonic follow-up was available in 102 (61.4%) of the patients. 54 (52.9%) patients had died and 32 (31.4%) remained unconscious (vegetative) at 6 months. Only 16 patients (15.7%) had a good outcome (GOS 1–2) at 6 months following an injury. CONCLUSIONS: This is the only study of its kind on patients who remain unconscious at discharge following severe TBI and reveals that around 50% will die and another 30% remains vegetative at 6 months of discharge. Only a small percentage (15% in our study) will become conscious and partially integrated in the society. Medknow Publications & Media Pvt Ltd 2015 /pmc/articles/PMC4692009/ /pubmed/26752896 http://dx.doi.org/10.4103/0976-3147.165394 Text en Copyright: © Journal of Neurosciences in Rural Practice http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
spellingShingle Original Article
Agrawal, Deepak
Singh, P. K.
Sinha, S.
Gupta, D. K.
Satyarthee, G. D.
Misra, M. C.
Remaining unconscious: The burden of traumatic brain injuries in India
title Remaining unconscious: The burden of traumatic brain injuries in India
title_full Remaining unconscious: The burden of traumatic brain injuries in India
title_fullStr Remaining unconscious: The burden of traumatic brain injuries in India
title_full_unstemmed Remaining unconscious: The burden of traumatic brain injuries in India
title_short Remaining unconscious: The burden of traumatic brain injuries in India
title_sort remaining unconscious: the burden of traumatic brain injuries in india
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4692009/
https://www.ncbi.nlm.nih.gov/pubmed/26752896
http://dx.doi.org/10.4103/0976-3147.165394
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