Potential Predictors of Prolonged Hospital Stay in Operated Traumatic Brain Injury at Tertiary Center in Northern India: Retrospective Analysis
International Journal of Neurology and Neurosurgery25 Original Article Volume 9 Number 1, January - June 2017 DOI: http://dx.doi.org/10.21088/ijnns.0975.0223.9117.4 Potential Predictors of Prolonged Hospital Stay in Operated Traumatic Brain Injury at Tertiary Center in Northern India: Retrospective Analysis Harsha A. Huliyappa*, Manish Jaiswal**, Bal Krishna Ojha***, Sunil Kumar Singh****, Anil Chandra****, Chhitij Srivastava***** Abstract Objective: Establishing a reliable prognosis after surgery for traumatic brain injury(TBI) is difficult. Majority of the prognostic models help in morbidity and mortality assessment. In a developing country, unexpected prolonged hospital stay can have a cumulative effect on limited hospital resources and lessen the caretaker’s compliance. Patients &Methods: Records of 256 patients who had hospital stay for more than 15 days during a period of 3 years were obtained and grouped into 15-30 days (Group 1) and > 30 days (Group 2) of hospital stay groups. Demographic data, comorbid factors, mode of injury, Glasgow coma scale (GCS), pupil status, Computed tomography (CT) features, tracheostomy, associated significant injuries, septic foci with cultures and second-surgeries were compared and analyzed. Results: In Group 1, age<50 years, GCS:3-5 at presentation, bilateral fixed but normal sized pupils, bilateral fixed and dilated pupils, CT features of Extradural hematoma (EDH), subdural hematoma (SAH), cerebral edema & Midline Shift (MLS) of >6mm were found to be significantly associated with prolonged stay (p<0.001). In Group 2, GCS 6-8, unilateral fixed and dilated pupils, CT features of SDH & ischemia and infarcts, associated orthopedic injuries, abdominal injuries and soft tissue loss, comorbidities, pneumonia, tracheostomy, wound infection, meningitis, and second surgery, were found to have significant association ( p<0.001).
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