ĐÁNH GIÁ KẾT QUẢ SỚM PHẪU THUẬT CHẤN THƯƠNG SỌ NÃO NẶNG TẠI BỆNH VIỆN ĐA KHOA TỈNH BẮC GIANG

Abstract

GENERAL HOSPITAL

Objective: Clinical characteristics and computed tomography (CT) imaging features of patients with severe traumatic brain injury at Bac Giang Provincial General Hospital from June 2023 to June 2024. Early outcome evaluation of severe traumatic brain injury surgery at Bac Giang Provincial General Hospital. Methods: A Retrospective descriptive study was conducted on 73 patients with severe traumatic brain injury treated surgically at Bac Giang Provincial General Hospital from June 2023 to June 2024. Results: In the study of 73 patients: The average age was 41,27 ± 17,1, with the youngest at 6 years and the oldest is 85. Males accounted for 76,71%, and females 23,29%, yielding a male-to-female ratio of 3/1. Traffic accidents were the cause in 71,2% of cases. At admission, 64,4% of the patients were comatose, 28,8% were semi-conscious, and 6,8% were conscious. Associated injuries were present in 29 patients (39,7%). Preoperative CT scans showed epidural hematomas in 26%, subdural hematomas in 15,1%, and combined injuries in 57,5% of cases. Midline shift >10mm to 15mm was observed in 43,8%, and 47,9% had obliterated basal cisterns. Surgery was performed within the first 6 hours after admission for 84,9%. The average hospital stay was 13,26 ± 1,27 days. At discharge, 76,7% of patients were stable, while 23,3% had died. Postoperative complication rates included hemorrhage at the surgical site (17,8%) and contralateral hemorrhage (6,8%), with two cases requiring reoperation. Two months post-surgery, Glasgow Outcome Scale (GOS) assessments indicated 26% mortality, 11% in a vegetative state, 12,3% with severe disability, 16,5% with mild disability, and 34,2% with good recovery. A lower preoperative Glasgow Coma Scale, preoperative pupil dilation, and preoperative motor paralysis were statistically significant risk factors for mortality (P≤0,05). Conclusion: In severe traumatic brain injury surgery, a high proportion of patients are male, with most admitted in a comatose state. CT scans reveal that combined injuries are the most common finding. Postoperative complications are relatively low. Poor preoperative consciousness and focal neurological signs increase the risk of mortality. The quality of life of patients improved two months after discharge, highlighting the role of rehabilitation.