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Potapov A.A.

Burdenko Neurosurgical Center

Danilov G.V.

Burdenko Neurosurgical Center

Sychev A.A.

Burdenko Neurosurgical Center

Zakharova N.E.

Burdenko Neurosurgical Center

Pronin I.N.

Burdenko Neurosurgical Center

Savin I.A.

Burdenko Neurosurgical Center

Oshorov A.V.

Burdenko Neurosurgical Center

Polupan A.A.

Burdenko Neurosurgical Center

Aleksandrova E.V.

Burdenko Neurosurgical Center

Strunina Yu.V.

Burdenko Neurosurgical Center

Likhterman L.B.

Burdenko Neurosurgical Center

Ohlopkov V.A.

FSAI «National Medical Research Center of Neurosurgery named after acad. N.N. Burdenko» Ministry of Health of Russia

Latyshev Ya.A.

Burdenko Neurosurgical Center

Chelushkin D.M.

Burdenko Neurosurgery Center

Baranich A.I.

Burdenko Neurosurgical Center

Kravchuk A.D.

FSAI «National Medical Research Center of Neurosurgery named after acad. N.N. Burdenko» Ministry of Health of Russia

Clinical and MRI predictors of coma duration, critical care intensity and outcomes in traumatic brain injury

Authors:

Potapov A.A., Danilov G.V., Sychev A.A., Zakharova N.E., Pronin I.N., Savin I.A., Oshorov A.V., Polupan A.A., Aleksandrova E.V., Strunina Yu.V., Likhterman L.B., Ohlopkov V.A., Latyshev Ya.A., Chelushkin D.M., Baranich A.I., Kravchuk A.D.

More about the authors

Journal: Burdenko's Journal of Neurosurgery. 2020;84(4): 5‑16

DOI: 10.17116/neiro2020840415

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Table of contents

CLINICAL AND MRI PREDICTORS OF COMA DURATION, CRITICAL CARE INTENSITY AND OUTCOMES IN TRAUMATIC BRAIN INJURY
CLINICAL AND MRI PREDICTORS OF COMA DURATION, CRITICAL CARE INTENSITY AND OUTCOMES IN TRAUMATIC BRAIN INJURY

To cite this article:

Potapov AA, Danilov GV, Sychev AA, et al. . Clinical and MRI predictors of coma duration, critical care intensity and outcomes in traumatic brain injury. Burdenko's Journal of Neurosurgery. 2020;84(4):5‑16. (In Russ., In Engl.)
https://doi.org/10.17116/neiro2020840415

Подписка 2025 Журнал «Вопросы нейрохирургии» имени Н.Н. Бурденко (Burdenko's Journal of Neurosurgery)
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Abstract:

OBJECTIVE

This research was aimed at studying the clinical and MRI predictors of coma duration, the intensity of critical care, and outcomes in patients with traumatic brain injury (TBI).

MATERIAL AND METHODS

309 patients with TBI of varying severity were included in the analysis, of whom 257 (86.7%) were treated in the intensive care unit (ICU), including 196 (63.4%) patients admitted in a comatose state lasting longer than 1 day. All patients underwent brain MRI within 21 days after the injury. MRI findings were classified according to MRI grading scale of brain damage level/localization proposed previously.

RESULTS

The proposed MRI grading significantly correlated with the Glasgow coma (GCS, r=–0.67; p<0.0001) and Glasgow outcome (0.69; p<0.001) scores in the entire group. In a subgroup of comatose patients (GCS<9) it correlated with coma duration (r=0.52; p<0.0001). Spearman correlation analysis showed a significant relationship between the MRI classification and a number of parameters: ICU length of stay (r=0.62; p<0.0001), the duration of mechanical ventilation (r=0.47; p<0.0001), the rate of mechanical ventilation, sedatives, analgesics, mannitol, a hypertonic solution of sodium chloride and vasopressors usage (p<0.01). A direct relationship was revealed between the grades of damage according to MRI classification and the need for the escalation of the main components of intensive care.

CONCLUSION

Our results support the hypothesis that the levels and localization of brain damage, estimated by the proposed MRI classification, might serve as predictors of coma duration, intensity and duration of intensive care and TBI outcomes. A prognosis based on clinical and neuroimaging data comparison can be valuable for planning and efficient use of the hospital beds and ICU resources, for optimizing the patient flow and timing for their further transfer to neurorehabilitation facilities.

Keywords:

traumatic brain injury
magnetic resonance imaging
classification
intensive care
outcome of traumatic brain injury

Authors:

Potapov A.A.

Burdenko Neurosurgical Center

Danilov G.V.

Burdenko Neurosurgical Center

Sychev A.A.

Burdenko Neurosurgical Center

Zakharova N.E.

Burdenko Neurosurgical Center

Pronin I.N.

Burdenko Neurosurgical Center

Savin I.A.

Burdenko Neurosurgical Center

Oshorov A.V.

Burdenko Neurosurgical Center

Polupan A.A.

Burdenko Neurosurgical Center

Aleksandrova E.V.

Burdenko Neurosurgical Center

Strunina Yu.V.

Burdenko Neurosurgical Center

Likhterman L.B.

Burdenko Neurosurgical Center

Ohlopkov V.A.

FSAI «National Medical Research Center of Neurosurgery named after acad. N.N. Burdenko» Ministry of Health of Russia

Latyshev Ya.A.

Burdenko Neurosurgical Center

Chelushkin D.M.

Burdenko Neurosurgery Center

Baranich A.I.

Burdenko Neurosurgical Center

Kravchuk A.D.

FSAI «National Medical Research Center of Neurosurgery named after acad. N.N. Burdenko» Ministry of Health of Russia

Received:

07.03.2020

Accepted:

24.04.2020

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