ABSTRACT
The aim of the study was to report management and outcome of traumatic brain injury (TBI) in a Jakarta University hospital, and to determine prognostic factors. All consecutive patients with an Abbreviated Injury Score (AIS) head of >=4 or an AIS head score of >=3 combined with an AIS score of >=2 in any other body region were analyzed on patient characteristics and outcome. Prognostic factors evaluated were Glasgow Coma Scale (GCS) score, pupil reactions and probability of survival based on the Trauma and Injury Severity Score (TRISS) method. A total of 49 patients were included; overall mortality was 37%. The GCS and abnormal pupil reactions were associated with mortality with an odds ratio of 0.78 and 6.90, respectively. Thus, TBI has a poor prognosis in the population under study. The TRISS has limitations in evaluating trauma care for this selected group of patients. GCS and pupil reactions are valuable and simple for usage as prognostic factors.
Subject(s)
Brain Injuries , Hospitals, University/statistics & numerical data , Treatment Outcome , Abbreviated Injury Scale , Adult , Brain Injuries/diagnosis , Brain Injuries/mortality , Brain Injuries/therapy , Disability Evaluation , Female , Glasgow Outcome Scale , Humans , Male , Odds Ratio , Prognosis , Prospective Studies , ROC Curve , Retrospective Studies , Risk Factors , Young AdultABSTRACT
BACKGROUND: In this prospective study, the TRISS methodology is used to compare trauma care at a University Hospital in Jakarta, Indonesia, with the standards reported in the Major Trauma Outcome Study (MTOS). METHODS: Between February 24, 1999, and July 1, 1999, all consecutive patients with multiple and severe trauma were included in the study (n = 105). Survival analysis was completed for 97 (92%) patients. RESULTS: The majority of patients were men (81%), and the average age was 28 years. Ninety-five patients (98%) sustained blunt trauma, with motor vehicle crashes being the most common (68%). The predicted mortality was 14% and the observed mortality was 29%. The Z and M statistics were 7.87 and 0.843, respectively. CONCLUSION: We conclude that in developing countries both institution-bound factors and specific limitations in the TRISS methodology are responsible for the difference between predicted and observed mortality, indicating the need for a regional database.
