Outcome predictors of Glasgow Outcome Scale score in patients with severe traumatic brain injury

Traumatic brain injury is a major public health problem due to high mortality and morbidity among survivors.

We performed a retrospective cohort study of patients with severe traumatic brain injury. We recorded the attending physician's evaluation of the patient's consciousness, the patient's demographics, routine physical measurements, and medical interventions. We used Glasgow Coma Scale and Extended Glasgow Outcome Scale.

We included 60 patients (83.3% males, mean age: 49.5 years). The Glasgow Coma Scale score was 4.8±1.9 and the Extended Glasgow Outcome Scale score was 2.9±2.5 points. Linear regression for higher Extended Glasgow Outcome Scale score explained 59.8% of the variance and revealed the duration of hospital stay and the presence of epidural hematoma as significant predictors. The classification tree for the higher Extended Glasgow Outcome Scale score revealed the following variables to be important: the duration of hospital stay, Glasgow Coma Scale score, partial pressure of carbon dioxide, surgery, response time of out-of-hospital emergency team, systolic and diastolic blood pressure, fall, and basis fracture.

Standardized inpatient protocol on monitoring, intervention and outcome recording should be adopted to make future comparisons more useful and to promote benchmarking between trauma centers in order to improve care for patients with severe traumatic brain injury.