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Deep coma does not always predict poor outcomes among patients with polytrauma.
Huang, Jen-Fu; Ou Yang, Chun-Hsiang; Fu, Chih-Yuan; Wu, Yu-Tung.
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  • Huang JF; Division of Trauma and Emergency Surgery, Chang Gung Memorial Hospital, 5 Fu-Xing Street, Guishan District, Taoyuan City, Taiwan, Republic of China.
  • Ou Yang CH; Division of Trauma and Emergency Surgery, Chang Gung Memorial Hospital, 5 Fu-Xing Street, Guishan District, Taoyuan City, Taiwan, Republic of China.
  • Fu CY; Division of Trauma and Emergency Surgery, Chang Gung Memorial Hospital, 5 Fu-Xing Street, Guishan District, Taoyuan City, Taiwan, Republic of China. drfu5564@gmail.com.
  • Wu YT; Division of Trauma and Emergency Surgery, Chang Gung Memorial Hospital, 5 Fu-Xing Street, Guishan District, Taoyuan City, Taiwan, Republic of China.
Eur J Trauma Emerg Surg ; 45(3): 455-460, 2019 Jun.
Article en En | MEDLINE | ID: mdl-29427061
PURPOSES: This study aimed to clarify the prognosis of polytrauma patients presenting to the emergency department (ED) with a Glasgow Coma Scale score (GCS) of 3. METHODS: A trauma registry system has been established at our institution since 2009. The current study reviewed patients in the registry who presented to the ED with a GCS of 3 from January 2011 to December 2015. Surviving and non-surviving patients were compared to identify the prognostic factors of patient survival. The study also aimed to determine the factors contributing to patients who survived with a GCS > 13 at discharge. RESULTS: During the study period, 145 patients were enrolled in the study, 119 of whom (82.1%) did not survive the traumatic insult. Of the 26 survivors, 13 (9.0%) had a GCS of 14 or 15 at discharge. The multiple logistic regression revealed that a lack of bilateral dilated and fixed pupils (BFDP) (OR 5.967, 95% CI 1.780-19.997, p = 0.004) and a GCS > 3 after resuscitation (OR 6.875, 95% CI 2.135-22.138, p = 0.001) were independent prognostic factors of survival. Based on the multiple logistic regression, an age under 40 years (OR 16.405, 95% CI 1.520-177.066, p = 0.021) and a GCS > 3 after resuscitation (OR 12.100, 95% CI 1.058-138.352, p = 0.045) were independent prognostic factors of a GCS > 13 at discharge. CONCLUSION: Aggressive resuscitation still provided benefit to polytrauma patients presenting with a GCS of 3, especially those with a rapid response to the resuscitation. Young patients with a deep coma on arrival had a higher probability of functional recovery after resuscitation in the ED.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Traumatismo Múltiple / Trastornos de la Pupila / Coma Postraumatismo Craneoencefálico Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Female / Humans / Male / Middle aged País/Región como asunto: Asia Idioma: En Revista: Eur J Trauma Emerg Surg Año: 2019 Tipo del documento: Article País de afiliación: China Pais de publicación: Alemania
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Traumatismo Múltiple / Trastornos de la Pupila / Coma Postraumatismo Craneoencefálico Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Female / Humans / Male / Middle aged País/Región como asunto: Asia Idioma: En Revista: Eur J Trauma Emerg Surg Año: 2019 Tipo del documento: Article País de afiliación: China Pais de publicación: Alemania