RT Journal Article
SR Electronic
T1 What are the strongest indicators of intracerebral hemorrhage in mild traumatic brain injury?
JF Trauma Surgery & Acute Care Open
JO Trauma Surg Acute Care Open
FD BMJ Publishing Group Ltd
SP e000717
DO 10.1136/tsaco-2021-000717
VO 6
IS 1
A1 Teeratakulpisarn, Panu
A1 Angkasith, Phati
A1 Wannakul, Thanakorn
A1 Tanmit, Parichat
A1 Prasertcharoensuk, Supatcha
A1 Thanapaisal, Chaiyut
A1 Wongkonkitsin, Narongchai
A1 Kitkhuandee, Amnat
A1 Sukeepaisarnjaroen, Wattana
A1 Phuttharak, Warinthorn
A1 Sawanyawisuth, Kittisak
YR 2021
UL http://tsaco.bmj.com/content/6/1/e000717.abstract
AB Background Although there are eight factors known to indicate a high risk of intracranial hemorrhage (ICH) in mild traumatic brain injury (TBI), identification of the strongest of these factors may optimize the utility of brain CT in clinical practice. This study aimed to evaluate the predictors of ICH based on baseline characteristics/mode of injury, indications for brain CT, and a combination of both to determine the strongest indicator.Methods This was a descriptive, retrospective, analytical study. The inclusion criteria were diagnosis of mild TBI, high risk of ICH, and having undergone a CT scan of the brain. The outcome of the study was any type of ICH. Stepwise logistic regression analysis was used to find the strongest predictors according to three models: (1) injury pattern and baseline characteristics, (2) indications for CT scan of the brain, and (3) a combination of models 1 and 2.Results There were 100 patients determined to be at risk of ICH based on indications for CT of the brain in patients with acute head injury. Of these, 24 (24.00%) had ICH. Model 1 found that injury due to motor vehicle crash was a significant predictor of ICH, with an adjusted OR (95% CI) of 11.53 (3.05 to 43.58). Models 2 and 3 showed Glasgow Coma Scale (GCS) score of 13 to 14 after 2 hours of observation and open skull or base of skull fracture to be independent predictors, with adjusted OR (95% CI) of 11.77 (1.32 to 104.96) and 5.88 (1.08 to 31.99) according to model 2.Discussion Open skull or base of skull fracture and GCS score of 13 to 14 after 2 hours of observation were the two strongest predictors of ICH in mild TBI.Level of evidence III.Data are available upon reasonable request.