First CT findings and improvement in GOS and GOSE scores 6 and 12 months after severe traumatic brain injury

Abstract

Primary objective: To analyse the association between individual initial computerized tomography (CT) scan characteristics and Glasgow Outcome Scale (GOS) and Extended Glasgow Outcome Scale (GOSE) improvement between 6 months and 1 year.

Methods and procedures: Two hundred and twenty-four adult patients with severe traumatic brain injury and Glasgow Coma Scale (GCS) score of 8 or less who were admitted to an intensive care unit were studied. GOS and GOSE scores were obtained 6 and 12 months after injury in 203 subjects. Patients were predominantly male (84%) and median age was 35 years.

Main outcomes and results: Traumatic Coma Data Bank (TCDB) CT classification was associated with GOS/GOSE improvement between 6 months and 1 year, with diffuse injury type I, type II and evacuated mass improving more than diffuse injury type III, type IV and non-evacuated mass; for GOS 43/155 (28%) vs 3/48 (6%) (χ² = 9.66, p < 0.01) and for GOSE 71/155 (46%) vs 7/48 (15%) (χ² = 15.1, p < 0.01). CT individual abnormalities were not associated with GOS/GOSE improvement, with the exception of subarachnoid haemorrhage, which showed a negative association with GOSE improvement (χ² = 4.08, p < 0.05).

Conclusions: TCDB CT scan classification and subarachnoid haemorrhage were associated with GOS/GOSE improvement from 6–12 months, but individual CT abnormalities were not associated.

• Severe traumatic brain injury
• Glasgow Outcome Scale
• Glasgow Coma Scale
• computerized tomography
• prognosis