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  • In-Hospital and One Year Outcome of 1281 Severe TBI Patients from India: A single Center study

    Final Number:

    Deepak Agrawal MBBS MS MCh; VK Kamal; RM Pandey

    Study Design:
    Clinical Trial

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2014 Annual Meeting

    Introduction: Although developing countries like India bear the maximum load of TBI, there is insufficient data on outcome of these patients in these countries Aims & Objectives: To assess the In-hospital mortality and 6 month Outcome of patients with severe TBI managed at a single institution in India

    Methods: This prospective study was carried out a level I trauma center in New Delhi over a 26 month period (May 2010 -July 2012). Clinical and radiological records of consecutive patients of severe TBI (GCS=8) were analyzed. Outcome assessment was done by assessing In-hospital mortality. 12 month outcome was assessed using GOS. A GOS 1-3 was considered as ‘Unfavorable' outcome and GOS 4-5 was considered as ‘favorable' outcome.

    Results: A total of 1281 patients were enrolled in the study. There were 1114 (87%) males & 167 (13%) females with the mean age of 31.96±16.42 years (range: 1-90 years). The overall mortality was 38.56% (n=494). Of the 523 patients with motor score of 5, 81 (14.65%) expired. The mortality was 29.38% (n=57) in patients with motor score of 4; 39.05% (n=41) in patients with motor score of 3; 63.53% (n=169) in patients with motor score of 2 and 91.19% (145) in patients with motor score of 1. Overall, 71.54% (n=646) had unfavorable outcome at 6 months. Unfavorable outcome were 39.94% (n=125) in patients with motor score of 5, 71.43% (n=95) in patients with motor score of 4, 85.71% (n=60) in patients with motor score of 3, 93.45% (n=214) in patients with motor score of 2 and 96.79% (n=151) in patients with motor score of 1.

    Conclusions: This is the largest single center study of its kind from the Indian subcontinent and shows that large number of severe TBI (28.45% in our study) had favorable outcome at 12 months. This study also shows that a significant number of patients with poor GCS may have good outcome and therefore aggressive management should be done for all severe TBI patients.

    Patient Care: Will provide a benchmark for other institutions in this region to compare outcomes

    Learning Objectives: This study shows the magnitude of TBI in India and the outcome of severe TBI in this part of teh part


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