Risk Factors of Schreiber et al for Mortality in Patients with Severe Blunt Head Injury

Description

Schreiber et al identified risk factors associated with mortality in patients who have suffered severe blunt head injury. This can help identify patients shortly after presentation who may benefit from more aggressive or innovative therapies. The authors are from Baylor College of Medicine in Houston.

Criteria for severe blunt head injury: inability to follow commands (Glasgow Coma Score <= 5)

Parameters associated with increased mortality:

(1) age >= 55 years and Glasgow coma score (GCS) <= 8 on admission

(2) absence of light reflex in either eye

(3) systolic blood pressure <= 90 mm Hg in the Emergency Department

(4) intracranial pressure >= 15 mm Hg

(5) midline shift in CT scan of head >= 5 mm

Parameter	Odds Ratio	95% CI
age and GCS	5.1	1.4 to 17.8
absence of light reflex	3.8	1.6 to 9.2
systolic blood pressure	5.1	1.4 to 18.6
intracranial pressure	4.4	2.1 to 9.0
midline shift	4.3	1.8 to 10.3

from Table 2, page 289

Age in Years	Glasgow Coma Score	Mortality Rate
< 55 years	> 8	22%
< 55 years	<= 8	40%
>= 55 years	> 8	27%
>= 55 years	<= 8	75%

from Figure 2, page 289

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Description

Specialty

ICD-10