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  1. Defining the limits of survivorship after very severe head injury.

    Article, Communication - En anglais

    Annual Meeting of the Congres of Neurological Surgeons. Chicago, Illinois (USA), 1994/10/01.


    Reliable prediction of outcome after head injury is a daunting task.

    Although previous reports have highlighted the difficulties of determining outcome in the cohort of severe head injury Glasgow Coma Scale (GCS) score ¾ 8), we wondered within the very severely injured population (GCS score 3-5) if a simple combination of clinical parameters may be predictive of poor outcome.


    All patients admitted to a Level 1 trauma center with a GCS score of 3 to 5 from 1986 to 1991 inclusive (380 patients) were retrospectively reviewed and outcome a minimum of 6 months after injury was determined by chart review or telephone.


    Follow-up was accomplished in all but five patients (1.3%). Functional survival (nonvegetative) was correlated to admission GCS score, pupillary abnormalities, and age.

    As anticipated, overall functional survival was poor (12.5%), and even worse among those evidencing pupillary abnormalities (6.6%). Interestingly, there was an absence of survivors in the advanced age decades, with the oldest functional survivor of any GCS increasing in a stepwise fashion with increasing coma score.

    This translated into the oldest survivor of a GCS score of 3 being in their chronologic 30s, a score of 4 in their 40s, and a score of 5 in their 50s.

    Among patients older than these age decades, that is beyond this simple age/GCS cut-off (32.8% of cohort), there were no functional survivors (95% confidence interval 0,2.4). (...)

    Mots-clés Pascal : Traumatisme, Crânioencéphalique, Gravité, Epidémiologie, Evaluation, Critère, Pronostic, Homme, Système nerveux pathologie, Système nerveux central pathologie, Encéphale pathologie, Système ostéoarticulaire pathologie, Crâne pathologie

    Mots-clés Pascal anglais : Trauma, Craniocerebral, Gravity, Epidemiology, Evaluation, Criterion, Prognosis, Human, Nervous system diseases, Central nervous system disease, Cerebral disorder, Diseases of the osteoarticular system, Skull disease

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    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 97-0147979

    Code Inist : 002B16B. Création : 21/05/1997.