A1 Vertaisarvioitu alkuperäisartikkeli tieteellisessä lehdessä

Contusion expansion, low platelet count and bifrontal contusions are associated with worse patient outcome following traumatic brain injury-a retrospective single-center study




TekijätAndersson, Alice S.; Hossain, Iftakher; Marklund, Niklas

KustantajaSpringer

Julkaisuvuosi2024

JournalActa Neurochirurgica

Tietokannassa oleva lehden nimiActa neurochirurgica

Lehden akronyymiActa Neurochir (Wien)

Artikkelin numero377

Vuosikerta166

ISSN0001-6268

eISSN0942-0940

DOIhttps://doi.org/10.1007/s00701-024-06269-7

Verkko-osoitehttps://doi.org/10.1007/s00701-024-06269-7

Rinnakkaistallenteen osoitehttps://research.utu.fi/converis/portal/detail/Publication/458292501


Tiivistelmä

Background

Cortical contusions are common in moderate-severe traumatic brain injury (TBI). Cortical contusions often expand, potentially causing neuro-worsening several hours to days post-trauma. While contusion expansion (CE) may affect outcome, potential clinical and radiological markers that can predict CE have been insufficiently explored. In the present single-center retrospective observational cohort study, we evaluated clinical outcome by the Glasgow Outcome Scale extended (GOSE) scale and evaluated risk factor for CE.

Method

Adult TBI patients > 18 years of age, and of all injury severities, were included. Main variables of interest were low platelet count, defined as < 150 × 109/L, presence of bifrontal contusions and CE, defined as absolute contusion volume increase in cm3. Factors associated with CE and clinical outcome according to GOSE were analyzed.

Results

Between 2012–2022, 272 patients were included. Contusion size on admission correlated positively with CE, as did the Marshall and Rotterdam radiological classification scores. Bifrontal contusions were significantly larger at admission, experienced larger CE, and had a worse outcome than contusions in other locations. Patients with a platelet count < 150 × 109/L experienced a greater volume CE and had a worse outcome when compared to patients with a normal platelet count. In a multivariate analysis, CE remained significantly associated with a poor outcome six months post- injury.

Conclusion

Contusion volume at admission, Marshall CT classification and Rotterdam CT score, positively correlated to CE. Bifrontal contusions and a platelet count < 150 × 109/L were associated with CE, and a poor clinical outcome. Large CE volumes were associated with a worse clinical outcome, and CE was per se associated with outcome in a multivariate analysis. Management of these risk factors for CE in the acute post-injury setting may be needed to attenuate contusion expansion and to improve clinical outcome in TBI patients suffering from cortical contusion injuries.


Ladattava julkaisu

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Julkaisussa olevat rahoitustiedot
Open access funding provided by Lund University. Elsa Schmitz Foundation (ASA), The Finnish Medical Foundation (IH), The Päivikki and Sakari Sohlberg Foundation (IH), The Paulo Foundation (IH), The Orion Research Foundation (IH), The Finnish Cultural Foundation (IH), Skåne University Hospital ALF funds (NM), Hans-Gabriel af Trolle Wachtmeister Foundation (NM), Swedish Brain Foundation (NM).


Last updated on 2025-27-01 at 19:55