Association Between Glasgow Coma Scale Trajectory and In-Hospital Mortality in Traumatic Brain Injury in the ICU: A...

Area of Science:

• Neurological assessment
• Traumatic Brain Injury (TBI)
• Critical Care Nursing

Background:

• Glasgow Coma Scale (GCS) is crucial for TBI neurological assessment.
• Static GCS measurements inadequately reflect TBI progression.
• Dynamic GCS assessment is needed for timely nursing interventions.

Purpose of the Study:

• To analyze GCS dynamic trajectories in the first 24 hours post-TBI in ICU.
• To determine the association between GCS trajectories and in-hospital mortality.
• To inform nursing neurological assessment and care planning for TBI patients.

Main Methods:

• Identification of five distinct GCS trajectory groups within 24 hours of ICU admission.
• Statistical analysis of GCS patterns and their correlation with in-hospital mortality.
• Exploration of interactions between GCS trajectories, age, and heart failure status.

Main Results:

• Five GCS trajectory groups were identified: stable low (G1), stable intermediate (G2), stable medium-high (G3), stable high (G4), and increasing (G5).
• Mortality was significantly lower in G2-G5 compared to the stable low G1 group.
• Age and heart failure status significantly modified the GCS trajectory-mortality relationship (p < 0.05).

Conclusions:

• Dynamic GCS trajectory analysis provides superior prognostic value over static GCS scores in TBI.
• Age and heart failure status are critical factors influencing GCS patterns and mortality risk.
• Recognizing neurological evolution patterns through GCS trajectories enhances TBI patient care planning and monitoring.