Severe traumatic brain injury : clinical course and prognostic factors
Traumatic brain injury (TBI) constitutes a major health problem and is a leading cause of long-term disability and death. Patients with severe traumatic brain injury, S-TBI, comprise a heterogeneous group with varying complexity and prognosis. The primary aim of this thesis was to increase knowledge...
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Umeå universitet, Rehabiliteringsmedicin
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ftumeauniv:oai:DiVA.org:umu-119826 2023-10-09T21:52:53+02:00 Severe traumatic brain injury : clinical course and prognostic factors Stenberg, Maud 2016 application/pdf image/jpeg http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-119826 eng eng Umeå universitet, Rehabiliteringsmedicin Umeå : Umeå universitet Umeå University medical dissertations, 0346-6612 1792 http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-119826 urn:isbn:978-91-7601-416-5 info:eu-repo/semantics/openAccess Severe traumatic brain injury outcome rehabilitation prognosis Other Medical Sciences not elsewhere specified Övrig annan medicin och hälsovetenskap Doctoral thesis, comprehensive summary info:eu-repo/semantics/doctoralThesis text 2016 ftumeauniv 2023-09-22T13:48:47Z Traumatic brain injury (TBI) constitutes a major health problem and is a leading cause of long-term disability and death. Patients with severe traumatic brain injury, S-TBI, comprise a heterogeneous group with varying complexity and prognosis. The primary aim of this thesis was to increase knowledge about clinical course and outcome with regard to prognostic factors. Papers I, II and III were based on data from a prospective multicentre observational study from six neurotrauma centers (NCs) in Sweden and Iceland of patients (n=103-114), 18-65 years with S-TBI requiring neurosurgical intensive care or collaborative care with a neurosurgeon (the “PROBRAIN” study). Paper IV and V were performed on a regional subset (n=37). In Paper I, patients with posttraumatic disorders of consciousness (DOC) were assessed as regards relationship between conscious state at 3 weeks and outcomes at 1 year. The number of patients who emerged from minimally conscious state (EMCS) 1 year after injury according to status at 3 weeks were: coma (0/6), unresponsive wakeful syndrome (UWS) (9/17), minimally conscious state (MCS) (13/13), anaesthetized (9/11). Outcome at 1 year was good (Glasgow Outcome Scale Extended (GOSE>4) in half of the patients in MCS (or anaesthetized) at 3 weeks, but not for any of the patients in coma or UWS. In Paper II, the relationships between clinical care descriptors and outcome at 1 year were assessed. A longer length of stay in intensive care, and longer time between discharge from intensive care and admission to inpatient rehabilitation, were both associated with a worse outcome on the GOSE. The number of intervening care units between intensive care and rehabilitation, was not significantly associated with outcome at 1 year. In Paper III, the clinical course of cognitive and emotional impairments as reflected in the Barrow Neurological Institute Screen for Higher Cerebral Functions (BNIS) and the Hospital Anxiety and Depression Scale (HADS) were assessed from 3 weeks to 1 year together with associations ... Doctoral or Postdoctoral Thesis Iceland Umeå University: Publications (DiVA) |
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Umeå University: Publications (DiVA) |
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ftumeauniv |
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English |
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Severe traumatic brain injury outcome rehabilitation prognosis Other Medical Sciences not elsewhere specified Övrig annan medicin och hälsovetenskap |
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Severe traumatic brain injury outcome rehabilitation prognosis Other Medical Sciences not elsewhere specified Övrig annan medicin och hälsovetenskap Stenberg, Maud Severe traumatic brain injury : clinical course and prognostic factors |
topic_facet |
Severe traumatic brain injury outcome rehabilitation prognosis Other Medical Sciences not elsewhere specified Övrig annan medicin och hälsovetenskap |
description |
Traumatic brain injury (TBI) constitutes a major health problem and is a leading cause of long-term disability and death. Patients with severe traumatic brain injury, S-TBI, comprise a heterogeneous group with varying complexity and prognosis. The primary aim of this thesis was to increase knowledge about clinical course and outcome with regard to prognostic factors. Papers I, II and III were based on data from a prospective multicentre observational study from six neurotrauma centers (NCs) in Sweden and Iceland of patients (n=103-114), 18-65 years with S-TBI requiring neurosurgical intensive care or collaborative care with a neurosurgeon (the “PROBRAIN” study). Paper IV and V were performed on a regional subset (n=37). In Paper I, patients with posttraumatic disorders of consciousness (DOC) were assessed as regards relationship between conscious state at 3 weeks and outcomes at 1 year. The number of patients who emerged from minimally conscious state (EMCS) 1 year after injury according to status at 3 weeks were: coma (0/6), unresponsive wakeful syndrome (UWS) (9/17), minimally conscious state (MCS) (13/13), anaesthetized (9/11). Outcome at 1 year was good (Glasgow Outcome Scale Extended (GOSE>4) in half of the patients in MCS (or anaesthetized) at 3 weeks, but not for any of the patients in coma or UWS. In Paper II, the relationships between clinical care descriptors and outcome at 1 year were assessed. A longer length of stay in intensive care, and longer time between discharge from intensive care and admission to inpatient rehabilitation, were both associated with a worse outcome on the GOSE. The number of intervening care units between intensive care and rehabilitation, was not significantly associated with outcome at 1 year. In Paper III, the clinical course of cognitive and emotional impairments as reflected in the Barrow Neurological Institute Screen for Higher Cerebral Functions (BNIS) and the Hospital Anxiety and Depression Scale (HADS) were assessed from 3 weeks to 1 year together with associations ... |
format |
Doctoral or Postdoctoral Thesis |
author |
Stenberg, Maud |
author_facet |
Stenberg, Maud |
author_sort |
Stenberg, Maud |
title |
Severe traumatic brain injury : clinical course and prognostic factors |
title_short |
Severe traumatic brain injury : clinical course and prognostic factors |
title_full |
Severe traumatic brain injury : clinical course and prognostic factors |
title_fullStr |
Severe traumatic brain injury : clinical course and prognostic factors |
title_full_unstemmed |
Severe traumatic brain injury : clinical course and prognostic factors |
title_sort |
severe traumatic brain injury : clinical course and prognostic factors |
publisher |
Umeå universitet, Rehabiliteringsmedicin |
publishDate |
2016 |
url |
http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-119826 |
genre |
Iceland |
genre_facet |
Iceland |
op_relation |
Umeå University medical dissertations, 0346-6612 1792 http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-119826 urn:isbn:978-91-7601-416-5 |
op_rights |
info:eu-repo/semantics/openAccess |
_version_ |
1779316085862957056 |