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"glasgow coma scale"

Yan Yan, Jian Song, Shun Yao, Yusong Gao, Guibao Peng, Chenglong Cao, Wei Liao, Wan Yang, Zhixian Lan, Haiyang Xie, He Huang, Hao Du, Guozheng Xu
BACKGROUND: To develop and validate a refined traumatic brain injury (TBI) classification system to supplement the existing systems which have limited accuracy for predicting long-term consciousness recovery. METHODS: The refined classification system was developed using medical records of 527 patients according to clinical presentations within 12-24 hrs after injury. Multiple linear regression was applied to identify protective and risk factors for Glasgow Coma Scale (GCS) and Glasgow Outcome Scale (GOS) score at 12-month follow-up...
October 16, 2018: Brain Injury: [BI]
Matthew P Kirschen, Josh Blinder, Aaron Dewitt, Megan Snyder, Rebecca Ichord, Robert A Berg, Vinay Nadkarni, Alexis Topjian
IntroductionNeurodevelopmental disabilities in children with CHD can result from neurologic injury sustained in the cardiac ICU when children are at high risk of acute neurologic injury. Physicians typically order and specify frequency for serial bedside nursing clinical neurologic assessments to evaluate patients' neurologic status.Materials and methodsWe surveyed cardiac ICU physicians to understand how these assessments are performed, and the attitudes of physicians on the utility of these assessments. The survey contained questions regarding assessment elements, assessment frequency, communication of neurologic status changes, and optimisation of assessments...
October 16, 2018: Cardiology in the Young
Cheng-Yang Hsieh, Chia-Cheng Lai, Jung-Shun Lee, Chin-Chung Tseng
PURPOSE: Patients with end-stage renal disease (ESRD) have higher risks of subdural hemorrhage (SDH) and subsequent 30-day mortality. However, evidences regarding optimal mode of dialysis therapy during acute management are sparse. We aimed to compare the outcomes of ESRD patients who received continuous peritoneal dialysis (CPD) or extended hemodialysis (EHD) after SDH and determined factors associated with 30-day mortality. METHODS: We retrospectively reviewed consecutive patients with SDH and ESRD in a medical center...
March 15, 2018: Acta Neurologica Taiwanica
Anibal Basile-Filho, Alessandra Fabiane Lago, Mayra Gonçalves Menegueti, Edson Antonio Nicolini, Roosevelt Santos Nunes, Silas Lucena de Lima, João Paulo Uvera Ferreira, Marcus Antonio Feres
Guidelines for patients with subarachnoid hemorrhage (SAH) management and several grading systems or prognostic indices have been used not only to improve the quality of care but to predict also the outcome of these patients. Among them, the gold standards Fisher radiological grading scale, Hunt-Hess and the World Federation of Neurological Surgeons (WFNS) are the most employed. The objective of this study is to compare the predictive values of simplified acute physiology score (SAPS) 3, sequential organ failure assessment (SOFA), and Glasgow Coma Scale (GCS) in the outcome of patients with aneurysmal SAH...
October 2018: Medicine (Baltimore)
Roberto Chalela, Lluis Gallart, Sergi Pascual-Guardia, Antonio Sancho-Muñoz, Joaquim Gea, Mauricio Orozco-Levi
Background: Hypercapnic encephalopathy is relatively frequent in severe exacerbations of COPD (ECOPDs), with its intensity usually being evaluated through clinical scales. Bispectral index (BIS) is a relatively new technique, based on the analysis of the electroencephalographic signal, which provides a good approximation to the level of consciousness, having already been validated in anesthesia. Objective: The objective of the study was to evaluate the utility of BIS in the assessment of the intensity of hypercapnic encephalopathy in ECOPD patients...
2018: International Journal of Chronic Obstructive Pulmonary Disease
Johan Undén, Stuart R Dalziel, Meredith L Borland, Natalie Phillips, Amit Kochar, Mark D Lyttle, Silvia Bressan, John A Cheek, Jocelyn Neutze, Susan Donath, Stephen Hearps, Ed Oakley, Sarah Dalton, Yuri Gilhotra, Franz E Babl
BACKGROUND: Clinical decision rules (CDRs) aid in the management of children with traumatic brain injury (TBI). Recently, the Scandinavian Neurotrauma Committee (SNC) has published practical, evidence-based guidelines for children with Glasgow Coma Scale (GCS) scores of 9-15. This study aims to validate these guidelines and to compare them with other CDRs. METHODS: A large prospective cohort of children (< 18 years) with TBI of all severities, from ten Australian and New Zealand hospitals, was used to assess the SNC guidelines...
October 12, 2018: BMC Medicine
Bogdan Ianosi, Max Gaasch, Verena Rass, Lukas Huber, Werner Hackl, Mario Kofler, Alois Josef Schiefecker, Alberto Addis, Ronny Beer, Paul Rhomberg, Bettina Pfausler, Claudius Thomé, Elske Ammenwerth, Raimund Helbok
BACKGROUND: Early pharmacological deep vein thrombosis (DVT) prophylaxis is recommended by guidelines, but rarely started within 48 hours. We aimed to analyze the effect of early (within 48h) versus late (>48h) DVT prophylaxis on hematoma expansion (HE) and outcome in patients with spontaneous intracerebral hemorrhage (ICH). METHODS: We analyzed 134 consecutive patients admitted to a tertiary neuro-intensive care unit with diagnosed spontaneous ICH, obtained informed consent and without previous anticoagulation, a severe coagulopathy, hematoma evacuation, early withdrawal of therapy or ineligibility for DVT prophylaxis according to our institutional protocol...
October 11, 2018: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
Vincent Darioli, Patrick Taffé, Pierre-Nicolas Carron, Fabrice Dami, Laurent Vallotton, Bertrand Yersin, Patrick Schoettker, Mathieu Pasquier
OBJECTIVE: The National Advisory Committee for Aeronautics (NACA) score is used by many emergency medical services to assess the severity of prehospital patients. Little is known about its discriminative performance regarding short-term mortality. PARTICIPANTS AND METHODS: We retrospectively included adult missions between 2008 and 2014 in a Swiss ground and air-based emergency medical services. We excluded uninjured or dead-on-scene patients. Primary outcome was assessment of the discriminative performance of the NACA score to classify the 48-h vital status of patients...
October 10, 2018: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
Zhi-Jie Hong, Cheng-Jueng Chen, De-Chuan Chan, Teng-Wei Chen, Jyh-Cherng Yu, Sheng-Der Hsu
The trauma team leader is a professional who receives and treats trauma patients. We aimed to evaluate whether or not the seniority of a qualified trauma team leader was a prognostic factor for multiple-trauma patients managed by a trauma team. This was a retrospective cohort study conducted at a Level I Trauma Center in North Taiwan. From January 2009 to December 2013, 284 patients were randomly assigned to one of two trauma team leaders (junior and senior leaders) on duty, irrespective of the seniority of the qualified trauma team leader...
October 9, 2018: Surgery Today
Patricia B Mills, Kaila A Holtz, Elena Szefer, Vanessa K Noonan, Brian K Kwon
OBJECTIVE: To identify early predictors and develop reliable, validated prediction models for development of problematic spasticity after traumatic spinal cord injury (SCI). DESIGN: Prospective cohort study of the Rick Hansen Spinal Cord Injury Registry (RHSCIR), retrospective review of inpatient medical charts. SETTING: Quaternary trauma center, rehabilitation center, community settings. PARTICIPANTS: Individuals with traumatic SCI between March 1, 2005, and March 31, 2014, prospectively enrolled in the Vancouver site RHSCIR...
October 9, 2018: Journal of Spinal Cord Medicine
Kelly E Hall, Manuel Boller, Jayme Hoffberg, Maureen McMichael, Marc R Raffe, Claire R Sharp
OBJECTIVE: To report summative data from the American College of Veterinary Emergency and Critical Care Veterinary Committee on Trauma (VetCOT) registry. DESIGN: Multi-institutional veterinary trauma registry data report. SETTING: VetCOT identified veterinary trauma centers (VTCs). ANIMALS: Dogs and cats with evidence of trauma presented to VTCs with data entered in the VetCOT registry September 1, 2013-March 31, 2017...
October 7, 2018: Journal of Veterinary Emergency and Critical Care
Fadi Al Daoud, Anne Drolet, Chase Carto, Haben Debessai, Gul Sachwani Daswani
Introduction: Traumatic Brain Injuries (TBIs) can range from mild to severe, and may result in increased intracranial pressure (ICP). Increased ICP causes hallmark physical signs, such as diaphoresis, emesis, fixed pupils, and altered mental status. Monitoring the patient's score on the Glasgow Coma Scale (GCS) and cranial CT scans are routine measures used in clinical practice to monitor the development of a TBI. Presentation of the case: A 6-year-old male fell off his father's shoulders and subsequently presented to ED for suspected head trauma...
November 2018: Annals of Medicine and Surgery
Asif Ali Hitawala, Piyush Garg, Abhay Jain, Ashish Nahar
We discuss a case of a 20-year-old female who presented with history of fever, vomiting, and decreased oral intake for 10 days followed by one episode of generalized tonic-clonic seizure and altered sensorium for 5-6 h. On arrival in the emergency room, she had Glasgow Coma Scale 3 (E1V1M1), both pupils fixed and dilated, low blood pressure, low oxygen saturation, and few gasping breaths. She appeared to be brain dead and was assumed to have a very poor prognosis. Investigations revealed severe hypokalemia...
September 2018: Indian Journal of Critical Care Medicine
Wei-Chih Liao, Wen-Chien Cheng, Biing-Ru Wu, Wei-Chun Chen, Chih-Yu Chen, Chia-Hung Chen, Chih-Yen Tu, Te-Chun Hsia
BACKGROUND: Carbon monoxide (CO), a colorless and odorless gas, is one of the common causes of poisoning-related deaths worldwide. CO poisoning can result in hypoxic brain damage and death, but intensive care can improve the likely outcome for critically ill patients. However, there is a paucity of clinical data regarding the prognostic factors and association between organ dysfunction and clinical outcome of patients treated for CO poisoning in the intensive care unit (ICU). METHODS: We performed a retrospective study of patients admitted to a university affiliated hospital ICU between July 2001 and December 2010 following CO poisoning...
October 5, 2018: Journal of the Formosan Medical Association, Taiwan Yi Zhi
So Mi Shin, Kyung Su Kim, Gil Joon Suh, Kyuseok Kim, Woon Yong Kwon, Jonghwan Shin, You Hwan Jo, Jae Hyuk Lee, Huijai Lee, Joonghee Kim, Yoon Sun Jung, Taegyun Kim, Kyoung Min You
AIM: Although various quantitative methods have been developed for predicting neurological prognosis in patients with out-of-hospital cardiac arrest (OHCA), they are too complex for use in clinical practice. We aimed to develop a simple decision rule for predicting neurological outcomes following the return of spontaneous circulation (ROSC) in patients with OHCA using fast-and-frugal tree (FFT) analysis. METHODS: We performed a retrospective analysis of prospectively collected data archived in a multi-centre registry...
October 4, 2018: Resuscitation
Keisuke Takai, Manabu Niimura, Hiroki Hongo, Motoyuki Umekawa, Akio Teranishi, Tomomichi Kayahara, Makoto Taniguchi
OBJECTIVE: The diagnosis and treatment of intracranial hypotension associated with a spinal cerebrospinal fluid (CSF) leak, especially in comatose patients, have yet to be established. METHODS: Clinical manifestations, neuroimaging findings, and treatment outcomes in 11 patients (Glasgow Coma Scale 10±4) were described and compared with 36 patients with normal consciousness. RESULTS: Patients with disturbed consciousness were diagnosed at a significantly older age (55±11 years; p<0...
October 4, 2018: World Neurosurgery
Christopher P Kellner, Frank Moore, Marc S Arginteanu, Alfred A Steinberger, Kevin Yao, Jacopo Scaggiante, J Mocco, Yakov Gologorsky
INTRODUCTION: Spontaneous cerebellar intracerebral hemorrhage (scICH) makes up approximately 10% of all cases of spontaneous ICH and carries a mortality of 20-50%. Suboccipital craniectomy is commonly performed for scICH causing brain stem compression or hydrocephalus but unfortunately has long anesthesia times and a high complication rate. We present a series of minimally invasive scICH evacuation as an alternative to traditional suboccipital craniectomy. METHODS: Operative records were retrospectively reviewed for patients presenting to a single center from 1/1/09 to 3/1/17...
October 3, 2018: World Neurosurgery
Venencia Albert, Subramanian Arulselvi, Deepak Agrawal, Hara Prasad Pati, Ravindra Mohan Pandey
OBJECTIVE/BACKGROUND: Early coagulopathy in isolated severe traumatic brain injury occurs despite lack of severe bleeding, shock, and fluid administration. We aimed to correlate coagulation activation/inhibition, thrombin generation and fibrinolysis with the development of acute trauma induced coagulopathy (TIC) and its effects on early mortality in isolated severe traumatic brain injury (iSTBI) patients. METHODS: A prospective screening of iSTBI patients was done for two years...
September 27, 2018: Hematology/oncology and Stem Cell Therapy
Jigang Chen, Xiaolin Qu, Zhenxing Li, Danfeng Zhang, Lijun Hou
BACKGROUND: Studies suggested that the neutrophil-to-lymphocyte ratio (NLR) was associated with unfavorable outcomes in different diseases such as intracerebral hemorrhage, cardiovascular problem, cancer, and severe traumatic brain injury (sTBI). We aimed to evaluate the relationship between peak NLR and 1-year outcomes in patients with sTBI. METHODS: We retrospectively reviewed the clinical data of patients with sTBI who were treated in our department between January 2013 and January 2017...
October 4, 2018: Neurocritical Care
Lara Camilleri
A 69-year-old man developed reduced consciousness of sudden onset. Examination and parameters were normal, except for a Glasgow Coma Scale (GCS) score of six. Brain imaging and blood tests were also normal, except for high plasma ammonia. His past medical history included epilepsy, hypertension and colitis. He was taking multiple antiepileptic medications, including sodium valproate, with no recent dose alterations. Medical intervention led to the sodium valproate being stopped and naloxone being administered...
October 2018: Clinical Medicine: Journal of the Royal College of Physicians of London
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