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Results of early cranial decompression as an initial approach for damage control therapy in severe traumatic brain injury in a hospital with limited resources

INTRODUCTION: Severe traumatic brain injury (sTBI) is a disease that generates significant mortality and disability in Latin America, and specifically in Colombia. The purpose of this study was to evaluate the 12-month clinical outcome in patients with sTBI managed with an early cranial decompressio...

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Autores principales: Charry, José D., Rubiano, Andrés M., Nikas, Christine V., Ortíz, Juan C., Puyana, Juan C., Carney, Nancy, Adelson, P. David
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4750344/
https://www.ncbi.nlm.nih.gov/pubmed/26933337
http://dx.doi.org/10.4103/0976-3147.172151
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author Charry, José D.
Rubiano, Andrés M.
Nikas, Christine V.
Ortíz, Juan C.
Puyana, Juan C.
Carney, Nancy
Adelson, P. David
author_facet Charry, José D.
Rubiano, Andrés M.
Nikas, Christine V.
Ortíz, Juan C.
Puyana, Juan C.
Carney, Nancy
Adelson, P. David
author_sort Charry, José D.
collection PubMed
description INTRODUCTION: Severe traumatic brain injury (sTBI) is a disease that generates significant mortality and disability in Latin America, and specifically in Colombia. The purpose of this study was to evaluate the 12-month clinical outcome in patients with sTBI managed with an early cranial decompression (ECD) as the main procedure for damage control (DC) therapy, performed in a University Hospital in Colombia over a 4-year period. MATERIALS AND METHODS: A database of 106 patients who received the ECD procedure, and were managed according to the strategy for DC in neurotrauma, was analyzed. Variables were evaluated, and the patient outcome was determined according to the Glasgow Outcome Score (GOS) at 12 months postinjury. This was used to generate a dichotomous variable with “favorable” (GOS of 4 or 5) or “unfavorable” (GOS of 1–3) outcomes; analysis of variance was performed with the Chi-square, Wilcoxon–Mann–Whitney and Fisher tests. RESULTS: An overall survival rate of 74.6% was observed for the procedure, At 12 months postsurgery, a favorable clinical outcome (GOS 4–5) was found in 70 patients (66.1%), Unfavorable outcomes in patients were associated with the following factors: Closed trauma, an Injury Severity Score >16, obliterated basal cisterns, subdural hematoma as the main injury seen on the admission computed tomography, and nonreactive pupils observed in the emergency department. CONCLUSION: Twelve months outcome of patients with sTBI managed with ECD in a neuromonitoring limited resource University Hospital in Colombia shows an important survival rate with favorable clinical outcome measure with GOS.
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spelling pubmed-47503442016-03-01 Results of early cranial decompression as an initial approach for damage control therapy in severe traumatic brain injury in a hospital with limited resources Charry, José D. Rubiano, Andrés M. Nikas, Christine V. Ortíz, Juan C. Puyana, Juan C. Carney, Nancy Adelson, P. David J Neurosci Rural Pract Original Article INTRODUCTION: Severe traumatic brain injury (sTBI) is a disease that generates significant mortality and disability in Latin America, and specifically in Colombia. The purpose of this study was to evaluate the 12-month clinical outcome in patients with sTBI managed with an early cranial decompression (ECD) as the main procedure for damage control (DC) therapy, performed in a University Hospital in Colombia over a 4-year period. MATERIALS AND METHODS: A database of 106 patients who received the ECD procedure, and were managed according to the strategy for DC in neurotrauma, was analyzed. Variables were evaluated, and the patient outcome was determined according to the Glasgow Outcome Score (GOS) at 12 months postinjury. This was used to generate a dichotomous variable with “favorable” (GOS of 4 or 5) or “unfavorable” (GOS of 1–3) outcomes; analysis of variance was performed with the Chi-square, Wilcoxon–Mann–Whitney and Fisher tests. RESULTS: An overall survival rate of 74.6% was observed for the procedure, At 12 months postsurgery, a favorable clinical outcome (GOS 4–5) was found in 70 patients (66.1%), Unfavorable outcomes in patients were associated with the following factors: Closed trauma, an Injury Severity Score >16, obliterated basal cisterns, subdural hematoma as the main injury seen on the admission computed tomography, and nonreactive pupils observed in the emergency department. CONCLUSION: Twelve months outcome of patients with sTBI managed with ECD in a neuromonitoring limited resource University Hospital in Colombia shows an important survival rate with favorable clinical outcome measure with GOS. Medknow Publications & Media Pvt Ltd 2016 /pmc/articles/PMC4750344/ /pubmed/26933337 http://dx.doi.org/10.4103/0976-3147.172151 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
Charry, José D.
Rubiano, Andrés M.
Nikas, Christine V.
Ortíz, Juan C.
Puyana, Juan C.
Carney, Nancy
Adelson, P. David
Results of early cranial decompression as an initial approach for damage control therapy in severe traumatic brain injury in a hospital with limited resources
title Results of early cranial decompression as an initial approach for damage control therapy in severe traumatic brain injury in a hospital with limited resources
title_full Results of early cranial decompression as an initial approach for damage control therapy in severe traumatic brain injury in a hospital with limited resources
title_fullStr Results of early cranial decompression as an initial approach for damage control therapy in severe traumatic brain injury in a hospital with limited resources
title_full_unstemmed Results of early cranial decompression as an initial approach for damage control therapy in severe traumatic brain injury in a hospital with limited resources
title_short Results of early cranial decompression as an initial approach for damage control therapy in severe traumatic brain injury in a hospital with limited resources
title_sort results of early cranial decompression as an initial approach for damage control therapy in severe traumatic brain injury in a hospital with limited resources
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4750344/
https://www.ncbi.nlm.nih.gov/pubmed/26933337
http://dx.doi.org/10.4103/0976-3147.172151
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