Seyed Mohammad Hosseininejad; Farzad Bozorgi; Seyyed Hosein Montazar; Reza Ali Mohammadpour; Gholamhossein Hajiaghaei
Volume 11, Issue 3 , July 2023, , Pages 119-124
Abstract
Objective: To investigate the use of prognostic markers such as C-reactive protein (CRP) and D-dimer forclinical outcomes in patients with mild traumatic brain injury (TBI).Methods: This cross-sectional study was conducted on patients with mild head trauma who were admittedto the Emergency Department ...
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Objective: To investigate the use of prognostic markers such as C-reactive protein (CRP) and D-dimer forclinical outcomes in patients with mild traumatic brain injury (TBI).Methods: This cross-sectional study was conducted on patients with mild head trauma who were admittedto the Emergency Department of Imam Khomeini Hospital (Sari, Iran). Data were collected from 2018 to2019. Age, sex, the time of injury hospitalization, length of hospitalization, length of unconsciousness, bloodpressure, heart rate, respiratory rate, and concomitant symptoms were all recorded using a pre-designedchecklist. The patient’s Glasgow Coma Scale (GCS), CRP, and D-dimer were also measured. Moreover, allpatients underwent CT scan.Results: This study included 74 patients with TBI. The mean age of the participants was 36.92±3.54. Themean CRP and D-dimer values were 5.69±0.77 and 0.58±0.11 in these patients, respectively. At the cut-offpoint of 11.50 for CRP, the sensitivity and specificity to detect the pathological lesions in CT scan was 75%and 95.50%, respectively (p<0.001). Additionally, with a D-dimer cut-off point of 0.90, the sensitivity andspecificity for diagnosing pathological lesions in CT scan were 100% and 98.50%, respectively (p<0.001).Conclusion: In general, the CRP and D-dimer levels of patients with mild TBI (GCS≥13) can be assessed toprotect against CT-induced radiation exposure and subsequent disorders; if they do not exhibit clinical signs toincrease the risk of adverse brain damage, such as reduced level of consciousness, drowsiness, and prolongedperiods of unconsciousness.
Amir Nik; Mohammad Sobhan Sheikh Andalibi; Mohammad Reza Ehsaei; Ahmadreza Zarifian; Ehsan Ghayour Karimiani; Gholamreza Bahadoorkhan
Volume 6, Issue 2 , April 2018, , Pages 141-145
Abstract
Objective: To compare the efficacy and functional outcome of Glasgow Coma Scale (GCS) score with that of Acute Physiology and Chronic Health Evaluation Score II (APACHE II) in patients with multiple trauma admitted to the ICU.Methods: This cross-sectional study included 125 patients with traumatic brain ...
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Objective: To compare the efficacy and functional outcome of Glasgow Coma Scale (GCS) score with that of Acute Physiology and Chronic Health Evaluation Score II (APACHE II) in patients with multiple trauma admitted to the ICU.Methods: This cross-sectional study included 125 patients with traumatic brain injury associated with systemic trauma admitted to the ICU of Shahid Kamyab Hospital, Mashhad, between September 2015 and December 2016. On the day of admission, data were collected from each patient to calculate GCS and APACHE II scores. Sensitivity, specificity, and correct outcome prediction was compared between GCS and APACHE II.Results: Positive predictive value (PPV) at the cut-off points was higher in APACHE II (80.6%) compared with GCS (69.2%). However, negative predictive value (NPV) of GCS was slightly higher in comparison with APACHE II. Moreover, the area under the receiver operating characteristic (ROC) curve for sensitivity and specificity of GCS and APACHE II showed no significant difference (0.81±0.04 vs. 0.83±0.04; p=0.278 respectively).Conclusion: Our study suggested that there was no considerable difference between GCS and APACHE II scores for predicting mortality in head injury patients. Both scales showed acceptable PPV, while APACHE II showed better results. However, the utilization of GCS in the initial assessment is recommended over APACHE II as the former provides higher time- and cost-efficiency.
Mohamadreza Saatian; Jamal Ahmadpoor; Younes Mohammadi; Ehsan Mazloumi
Volume 6, Issue 1 , January 2018, , Pages 45-53
Abstract
Objective: To determine the epidemiological aspects of patients with traumatic brain injury (TBI) in a regional trauma center.Methods: A cross-sectional study was conducted on patients with TBI during 2013 to 2016 in a single center in Hamedan, central Iran. The distribution and relationships of TBI ...
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Objective: To determine the epidemiological aspects of patients with traumatic brain injury (TBI) in a regional trauma center.Methods: A cross-sectional study was conducted on patients with TBI during 2013 to 2016 in a single center in Hamedan, central Iran. The distribution and relationships of TBI was assessed with gender, age, type of trauma, traumatic cause, exiting status and Length of Hospitalization (LOH). Data were analyzed by Stata V11 statistical software.Results: In general, 9426 patients with TBI were enrolled in analyses. The mean ± SD age of patients was 29.70 (± 21.46) years. Multivariate logistic regression indicated that being male [OR: 1.29; 95% CI (2.92-4.73), P ≤0.001], 41-50 to 71-80 and 90+ years old' age groups (1.32<OR<3.12, 0.029<p≤0.001), having surgery [OR: 5.58; 95% CI (4.89-6.37), p≤0.001], and different types of trauma (p≤0.001) were significantly related to LOH. Moreover, odds ratio of mortality was 1.52 times greater in males than females (p≤0.001). As the age increases, the odds ratio of mortality was also rising. However, having surgery [OR: 3.72; 95% CI (2.92-4.73), p≤0.001], LOH >5 days [OR: 2.01; 95% CI (1.60-2.52), p≤0.001] and different types of trauma were significantly related to mortality.Conclusion: TBI is one of the main causes of mortality and LOH of the young population. By providing preventive measures and a traumatic care system, the burden of trauma can be greatly reduced, the implementation of the trauma care system in Hamedan province is a necessity.
