Brain Inj. 2016 Mar 10:1-11. [Epub ahead of print]
Prieto-Palomino MA(1), Curiel-Balsera E(1), Arias-Verdú MD(1), Der Kroft MD(2),
Muñoz-López A(1), Fernández-Ortega JF(1), Quesada-García G(1), Sanchez-Cantalejo
E(3), Rivera-Fernández R(4).
PURPOSE: This paper studies the relationship between computed tomography (CT)
scan on admission, according to Marshall’s tomographic classification, and
quality-of-life (QoL) after 1 year in patients admitted to the Intensive Care
Unit (ICU) with traumatic brain injury (TBI).
METHODS: This study used validated scales including the Glasgow Outcome Scale and
the PAECC (Project for the Epidemiologic Analysis of Critical Care Patients) QoL
questionnaire.
RESULTS: We enrolled 531 patients. After 1 year, 171 patients (32.2%) had died
(missing data = 6.6%). Good recovery was seen in 22.7% of the patients, while 20%
presented moderate disability. The PAECC score after 1 year was 9.43 ± 8.72
points (high deterioration). Patients with diffuse injury I had a mean of 5.08
points vs 7.82 in those with diffuse injury II, 11.76 in those with diffuse
injury III and 19.29 in those with diffuse injury IV (p < 0.001). Multivariate
analysis found that QoL after 1 year was associated with CT Marshall
classification, depth of coma, age, length of stay, spinal injury and
tracheostomy.
CONCLUSIONS: Patients with TBI had a high mortality rate 1 year after admission,
deterioration in QoL and significant impairment of functional status, although
more than 40% were normal or self-sufficient. QoL after 1 year was strongly
related to cranial CT findings on admission.
