Recovery of Patients with Pure Diffuse Axonal Injury Who Remained in a Coma for 6 Hours or More

Publication date: January 2018
Source:World Neurosurgery, Volume 109
Author(s): Rita de Cássia Almeida Vieira, Wellingson Silva Paiva, Daniel Vieira de Oliveira, Vinícius Monteiro de Paula Guirado, Ellen de Fátima Caetano Lança, Regina Márcia Cardoso de Sousa
BackgroundDiffuse axonal injury (DAI) is a traumatic brain injury and one of the most common causes of unfavorable outcome and death. The aim of this study was to investigate the recovery of patients with pure DAI who remained in a coma for 6 hours or longer after brain injury.MethodsThis was a follow-up study of 75 patients diagnosed with pure DAI, aged 18–60 years, with a Glasgow Coma Scale score ≤8 at hospital admission. Patient data were collected at hospital admission, hospital discharge, and 3 and 6 months after DAI. Recovery was assessed by score changes in the Katz Index of Independence in Activities of Daily Living and Extended Glasgow Outcome Scale.ResultsThe percentage of patients in a coma for 6–24 hours, >24 hours without brainstem signs, and >24 hours with brainstem signs was 42.7%, 20%, and 37.3%, respectively. The 6-month mortality rate was 32.0%, and the mean Extended Glasgow Outcome Scale score among survivors decreased from 3.8 at discharge (SD = 1.2) to 2.1 at 3 months (SD = 1.6) and 1.2 at 6 months (SD = 1.6). The mean Katz Index of Independence in Activities of Daily Living scores were 8.5 (SD = 5.5), 3.5 (SD = 5.8), and 1.8 (SD = 4.5) at discharge and 3 and 6 months after trauma, respectively. Statistically significant differences were observed among the 3 evaluation periods.ConclusionsMortality was high among patients with DAI, but almost all survivors had favorable outcomes at 6 months. Functional improvement was more pronounced in the first 3 months.



from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2yHdx8s