Factors influencing the functional outcome in a neurointensive care unit

Introduction

The aim of the present study was to investigate the factors that affect the outcome of patients with central nervous system pathology.

Method

One hundred and thirty patients (head injury [n = 43], multiple trauma [n = 40], cerebral hemorrhage [n = 36] and emergency cerebral aneurysm repair [n = 11]) were investigated for age, GCS, CT-Scan grade, ISS, and APACHE II. Male to female ratio was 96/34. The patients were divided in five groups according to Glasgow Outcome Scale: 1) group A, n = 50 (GOS 1, death), 2) group B, n = 5 (GOS 2, severe brain damage), 3) group C, n = 17 (GOS 3, moderate brain damage), 4) group D, n = 28 (GOS 4, mild disability) and 5) group E, n = 30 (GOS 5, full recovery).

Results

Total mortality was 38.4%. There was a statistically significant difference (one way analysis of variance ANOVA) regarding: 1) age: groups A, B and C versus E, 2) GCS: group A versus E, 3) CT-Scan grade: group A versus D and E, 4) ISS: group C versus D and E and 5) APACHE II score: group C versus E (Table). Patients with head injury or multiple trauma had better outcome than patients with cerebral hemorrhage (Fig.).

Figure

Relation of diagnosis to GOS

Table

Conclusion

Age, GCS and CT-Scan grade were related to the patient outcome regarding life or death whereas diagnosis, age, ISS and APACHE II determined the severity of disability.