[Progress in the treatment of severe craniocerebral injuries?]

This retrospective study of patients with severe head injuries requiring ICU admission between 1980 and 1982 was undertaken to determine to what extent head injury affected patients' outcome and whether there was any difference from patients admitted before the availability of CT scan for diagnosis. The 598 patients admitted between 1980 and 1982 underwent further analysis, and the long-term results were assessed 7 years postinjury for 427 patients (71%). These results are compared with those of a similar study made in 1985 in a comparable group of patients admitted to the same ICU just before the introduction of CT. We found that the long-term results were much better than those observed after 1 or 2 years. Many of the moderately disabled patients had learned to deal with their handicap and adapt better after several years, whereas most of the severely disabled or vegetative patients had died. The mortality rate was 51%. Using the Glasgow Outcome Scale, we found that 82% of the surviving patients had made a good recovery (GOS V), while 7% were moderately (GOS IV) and 11% severely disabled (GOS III). Seven years postinjury no patient was in a vegetative state (GOS II). Compared with the group treated before the use of CT scan we found more patients in GOS category V. The percentage of moderately disabled patients in GOS category IV had diminished, but the number of severely disabled patients and the mortality rate had not changed.(ABSTRACT TRUNCATED AT 250 WORDS)