NHẬN XÉT GIÁ TRỊ TIÊN LƯỢNG CỦA MỘT SỐ ĐẶC ĐIỂM LÂM SÀNG VÀ TỔN THƯƠNG NÃO LÚC NHẬP VIỆN Ở BỆNH NHÂN CHẤN THƯƠNG SỌ NÃO NẶNG TẠI BỆNH VIỆN QUÂN Y 105

Abstract

Objective: Objective: To study the prognostic value of some clinical symptoms at admission and brain damage on the treatment outcome of patients with severe traumatic brain injury (TBI). Methods: The study was prospectively conducted on 68 patients with severe traumatic brain injury treated at Military Hospital 105 from April 2024 to March 2025. Clinical and paraclinical signs were collected according to the study medical records, and the progression to treatment outcome was monitored. Treatment outcome was expressed by the overall mortality rate and mortality between the groups: mechanical ventilation and non-mechanical ventilation; deep coma and shallow coma; dilated and non-dilated pupils; epidural hematoma and non-epidural hematoma; brainstem hemorrhage and non-brainstem hemorrhage; surgery and non-surgery. Results: The overall mortality rate was 25%. The mortality rate did not differ between men and women, the group requiring mechanical ventilation upon admission and the group not requiring mechanical ventilation upon admission. But the mortality rate increased in the deep coma group (p=0.023; OR=12.3; CI: 3.84 - 14.63); the dilated pupil group (p=0.025; OR=18; CI: 11.21 - 19.143); and the brainstem hemorrhage group (p=0.001; OR=6.67; (CI: 1.14 - 8.23). In contrast, the mortality rate was lower in the simple epidural hematoma group (OR = 0.012) and the group of patients with indications and undergoing craniotomy, the non-surgical group was higher than the surgical group (p < 0.05). Conclusion: The mortality rate increased in patients with severe traumatic brain injury with deep coma, dilated pupil, basal cistern effacement and brainstem hemorrhage.