Traumatismo craneoencefálico leve

INTRODUCTION: Mild traumatic brain injury (TBI) represents a major health concern, because a sizeable number of patients with mild TBI will develop potentially life-threatening complications. The target of this study was to describe a large series of adult patients suffering from mild TBI, treated at University Hospital of Getafe, between 2010 and 2015 (n = 2480). We examined the patients’ epidemiological and baseline clinical profile, diagnosis, treatment and ultimate outcomes, to identify major prognostic factors that influence the final result. METHODS: We retrospectively extracted patient data from medical records and performed both bivariate and multivariate statistics. RESULTS: In our sample, mild TBI was more common in men, and the most common causative mechanism was a traffic accident. We proposed a model for classifying patients according to risk, dividing them into low, intermediate and high risk, based upon their baseline clinical picture. This classification scheme correlated well with final outcomes. We investigated indications for skull radiography and computed tomography (CT), as well as for hospital admission for clinical observation. CONCLUSIONS: In this study, the presence of a neurological focus on clinical examination, the existence of a fracture on plain radiographs, advanced age and the presence of a coagulation disorder were associated with the increased likelihood of intracranial complications and a poor prognosis. The Glasgow Coma Scale was deficient predicting patient outcomes, because it failed to account for concussion-related symptoms like amnesia and loss of consciousness, both very common in patients with mild TBI.