Is The Combination of Glasgow Coma Scale and Transcranial Doppler Pulsatility Index Improving The Prediction of Outcome in Traumatic Brain Injury Patients? | ||
| Zagazig University Medical Journal | ||
| Article 6, Volume 25, Issue 4, July 2019, Pages 529-538 PDF (178.18 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/zumj.2019.10082.10740 | ||
| Authors | ||
| Naglaa F. Abdelhaleem; Howaydah A. Othman; Ghada M. Abdel Razek; hmed H. S. Soliman; Essam F. Abdel Galel | ||
| Abstract | ||
| Background: Glasgow coma scale (GCS) is a familiar scoring system with a standard statistical association with neurological outcome, it has many limitations that minimize its ability in prediction of Traumatic brain injury (TBI) patients' outcome. Transcranial Doppler (TCD) is a noninvasive aid in this field that can improve outcome prediction. Objective: This study aims to explore the effect of combination of GCS and Pulsatility Index (PI) in the prediction of outcome of TBI patients. Patients and Method: This study was performed in Zagazig University Hospital (ZUH). 103 traumatic brain injured patients were engaged in the investigations with hospital days of 1, 2, 3, and 7 or until patient discharge. The study was performed by TCD along with GCS recordings. Prognosis was also assessed by the Glasgow outcome scale (GOS). Results: The sensitivity and negative predictive value of PI was more than GCS in TBI patients (GCS 3-15), as they were (67.5% versus 50%) and (81.1% versus 74.3%), respectively. The combination of both PI and GCS increased the sensitivity and the negative predictive value up to 70% and 83.3%, respectively. PI had higher sensitivity, positive and negative predictive values than GCS in the identification of secondary neurologic deterioration (SND) in mild and moderate TBI patients (73.3% versus 40.0%, 61.1% versus 50.0%, and 92.0% versus 83.9%, respectively), while the combined value of both PI and GCS increased both sensitivity and positive predictive value up to 76.7% and 66.7%, respectively. Conclusion: The combination of GCS and PI would improve the prediction of outcome. | ||
| Keywords | ||
| Transcranial Doppler; Traumatic brain injury; Pulsatility Index; Glasco coma scale | ||
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