ABSTRACT
Trauma is the third leading cause of death and is one of the most common causes for referrals to the emergencies. Assessment of prognosis in the patients with head trauma can help find high risk patients and provide more complete care to them. The evaluation includes assessment of intracranial pressure and the brain circulation with Trans Cranial Doppler [TCD]. The evaluation of prognosis in patients with moderate head trauma using pulsatility index [PI], obtained by Trans Cranial Doppler [TCD]. In this descriptive study, 52 patients with moderate head trauma [GCS= 9-13] were studied during one year [2010]. In the first 24 hours after trauma, for all the patients TCD by their middle cerebral arteries [MCA] was performed to assess PI value. After seven days, all the patients were followed up for neurological deterioration and prognosis. Finally, data were entered in SPSS software v.17 and analyzed by Independent T-test, Chi- square test with 95% Confidence Interval [CI=0.95]. In total, 47 [90.4%] were men and 5 [9.6%] were women [with mean age of 33.81 +/- 17.91 years]. In the group with low PI [<1.2], 29 [69.05%], patients were with good prognosis, and 13 [30.95%] with poor prognosis. There was a significant relationship between GCS decline >/= 2 and average of PI [p<0.021]. Average of PI in the patients who needed intubation [1.08 +/- 0.26] was higher than that in other patients [0.91 +/- 0.24, p<0.037]. Also, 32 [61.54%] patients were with good prognosis, finally. Average values of PI in good and poor prognosis groups were 0.88 +/- 0.24 and 1.08 +/- 0.24, respectively; with significant difference [p<0.005]. There was no significant relationship between average values of PI and gender, need for operating, osmol therapy and type of defect in CT scan. By using Roc curve, the best cut off point for PI was estimated at about 0.9 with sensitivity of 75% and specificity of 43%. The results demonstrated that the PI is a valuable parameter besides the other factors such as GCS decline, to determine the prognosis in the patients with moderate head injury admitted to emergency units