Nuance and profound impact: Evaluating the effects of the unmet full coma scale in patients with mild subdural hemorrhage.
Am J Emerg Med
; 77: 60-65, 2024 03.
Article
en En
| MEDLINE
| ID: mdl-38103392
ABSTRACT
INTRODUCTION:
Patients with subdural hemorrhage (SDH) and a Glasgow Coma Scale (GCS) score of 13-15 are typically categorized as having mild traumatic brain injury. We hypothesize that patients without a maximum GCS score - specifically, patients with GCS scores of 13 and 14 - may exhibit poorer neurological outcomes.METHOD:
Between January 1, 2019, and December 31, 2020, SDH patients with GCS scores ranging from 13 to 15 were retrospectively studied. We compared outcomes between patients with a maximum GCS score of 15 and those with scores of either 13 or 14. Independent factors associated with neurological deterioration among patients with a GCS score of 15 were evaluated using multivariate logistic regression (MLR) analysis.RESULTS:
During the study period, 470 patients with SDH and GCS scores between 13 and 15 were examined. Compared to patients with a maximum GCS score (N = 375), those in the GCS 13-14 group (N = 95) showed significantly higher rates of neurological deterioration (33.7% vs. 10.4%, p value <0.001) and neurosurgical interventions (26.3% vs. 16.3%, p value <0.024). Moreover, the GCS 13-14 group had a significantly poorer prognosis than patients with a GCS score of 15 [mortality rate 7.4% vs. 2.4%, p value <0.017; rate of impaired consciousness at discharge 21.1% vs. 4.0%, p value <0.001; and rate of neurological disability at discharge 29.5% vs. 6.9%, p value <0.001]. The MLR analysis revealed that SDH thickness (odds ratio = 1.127, p value = 0.006) was an independent risk factor for neurological disability at discharge in patients with a GCS score of 15.CONCLUSION:
Among SDH patients with mild TBI, those with GCS scores of 13-14 exhibited poorer neurological outcomes than those with a maximum GCS score. The thickness of the SDH is positively associated with neurological disability in SDH patients with a maximum GCS score.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Coma
/
Hematoma Subdural
Límite:
Humans
Idioma:
En
Revista:
Am J Emerg Med
Año:
2024
Tipo del documento:
Article
País de afiliación:
Taiwán