[Prognostic factors in severe traumatic brain injury]

To describe the factors associated to mortality of patients with severe traumatic brain injury (TBI).

A retrospective observational study was made of patients with severe TBI covering the period between 1 January 2007 and 31 December 2010.

Virgen de la Vega Hospital, Salamanca (Spain).

All patients hospitalized during the consecutive study period.

The dependent variable has been the death rate, while the independent variables were divided into two groups: epidemiological and clinical.

The mean patient age was the 50.84 years; 75.5% were males. The average score on the Glasgow Coma Scale (GCS) was 5.09, and the average Injury Severity Score (ISS) was 30.8. Higher mortality was observed in older patients with a higher ISS score. A total of 68.1% of the patients in which intracranial pressure (ICP) was monitored showed intracranial hypertension (ICH). The mortality rate in patients with severe TBI was 36.8%, and was associated mainly to a lower GCS score, the existence of hyperglycemia, coagulopathy, hypoxemia, the presence of mydriasis and shock. The independent mortality indicators in patients with severe TBI were the existence of mydriasis (OR: 32.75), the GCS score (OR: 2.65) and hyperglycemia (OR: 6.08).

The existence of mydriasis, the GCS score and hyperglycemia should be taken into account as prognostic factors in TBI patients.