Commonly available CT characteristics and prediction of outcome in traumatic brain injury patients

Abstract

Background: Acute Computerized Tomography (CT) characteristics are used widely and most accepted for prediction of outcome among Traumatic Brain Injury (TBI). The commonly available and simple combinations of existing and unexplored CT parameters may be more useful in prediction of outcome. The present study explores commonly available CT characteristics by possible combinations based on anatomical basics.
Methods: Abnormal CT sign was considered with any cranial lesion. Based on anatomical locations of cortical lobes, nine possibilities were made that include individual and combinations of mentioned lobes. The laterality was either right or left or bilateral. The outcome was favourable or unfavourable based on discharge Glasgow Outcome Scale (GOS). Binary logistic regression was used to predict outcome.
Results: 452 patients were recruited in the present study. There was significant risk of unfavourable outcome among patients with location of Sub Dural Haemorrhage (SDH) in Parietal + Temporal region (OR=10,p<0.001); Cerebral Contusion in Temporal region (OR=3,p=0.03), Frontal + Temporal region(OR=16,P=0.001), Frontal + Parietal + Temporal region (OR=18.7,p<0.001). Patients with four abnormal CT signs had worst outcome. Presence of SDH on right side (OR=4.5,p<0.001) and bilateral Cerebral Contusion (OR=4.5,p=0.003) was at the risk of unfavourable outcome.
Conclusion: The present study based on anatomical classification has shown that location and laterality of lesion can significantly predict TBI outcome.