Association of Clinical - Neurophysiological Variables with Mortality in Severe Craneoencephalic Trauma

Alain Cruz Portelles; Raul Ramírez Pupo; Bernardo E. Fernández Chelala; Idaer Batista Ojeda; Pura Avilés Cruz; Celso Ricardo Marrero

2012, Number 1

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Correo Científico Médico 2012; 16 (1)

Association of Clinical - Neurophysiological Variables with Mortality in Severe Craneoencephalic Trauma

Cruz PA, Ramírez PR, Fernández CBE, Batista OI, Avilés CP, Marrero CR

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Language: Spanish
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ABSTRACT

BACKGROUND: the high mortality after a severe craneoencephalic trauma could be attenuated if the patient receive an optimal multiple intensive neuromonitoring. OBJETIVES: to determine the possible association of clinical and neurophysiological variables with the mortality after a severe craneoencephalic trauma. METHODS: A prospective, series of cases study was performed in 27 patients admitted in a Intensive Care Unit of V. I. Lenin Hospital in Holguin during 2008-2009 after suffering from a severe craneoencephalic trauma and were follow until discharged. The qualitative and discrete variables were compared with Chi square test; the Glasgow Coma Scale at admission with the mode; the continuous one were measured with rate scale and their means compared with T-Student. The evolutive analysis of neurophysiological variables (jugular oxygen saturation, oxygen arteriovenous difference, oxygen cerebral extraction and modified lactate- oxygen index) was done with Kruskal-Wallis test for 95% of confidence interval. RESULTS: Higher mortality was observed in men (92%), with lower mean arterial pressure (71.22±15.2 vs. alive: 93.33±12.32, p=0.0006), lower Glasgow Coma Scale at admission (mode=6 vs. alive: mode=7) and higher Marshall tomographic scale on admission. Jugular oxygen saturation and oxygen arteriovenous difference were not associated with the mortality. Oxygen cerebral extraction decreased and modified lactate-oxygen index increased significantly in the patients who died. CONCLUSIONS: Mortality was significantly associated with lower mean arterial pressure on admission, an evolutional increase of modified lactate-oxygen index and a decrease in the oxygen cerebral extraction.

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