Comprehensive Summary
Jung et al. evaluated outcomes and prognostic factors in patients with severe TBI and abdominal trauma. A retrospective study was conducted from 2016 to 2020 at a Level 1 trauma centre at Ajou University Hospital, South Gyeonggi Regional Trauma Center. During those four years, patients who met the inclusion criteria, who had a TBI Abbreviated Injury Scale (AIS) score >3, an abdominal injury AIS score >3, and were older than 16 years of age were included. 4,554 patients were screened, and 160 met the inclusion criteria, of which 20.6% had an in-hospital mortality rate and 63.1% had achieved favorable functional outcomes. Independent predictors of mortality included lower MAP, higher base deficit, reduced GCS, prolonged aPTT, thrombocytopenia, and low fibrinogen. Poor functional outcomes were further ascribed with a head AIS score of 5 and massive transfusion requirement. The authors of the study proffered a management algorithm balancing urgent neurosurgical and abdominal interventions, underscoring hemodynamic stability, ICP monitoring, and timely surgery.
Outcomes and Implications
Outcomes and mortality for patients with both TBI and abdominal trauma injury were analyzed, a vulnerable population with limited management guidelines. The combination of neuro and abdominal injuries challenges the ability to provide the best care possible to patients since they often call for conflicting interventions, thereby making management difficult. Identifying prognostic factors can sway decisions on surgery, transfusion, and hemodynamic management in critically injured patients. Such findings in the clinical realm help delineate predictors that can guide surgical interventions, transfusion strategies, and hemodynamic targets in the acute setting. These findings are inextricably relevant to trauma and neurosurgery teams and may inform future practice, though prospective trials are warranted.