ORIGINAL
Introdução: O traumatismo cranioencefálico (TCE) é o trauma mais prevalente e com maior morbidade, afetando principalmente pacientes jovens. Na maioria dos casos incapacita suas vítimas, podendo deixar sequelas definitivas. A busca por melhores desfechos neurológicos é uma constante neste trauma, sendo o tempo pré-hospitalar uma possível variável de impacto. Neste estudo foi analisada a variável tempo pré-hospitalar e seu impacto sobre o desfecho neurológico de vítimas de TCE grave e moderado. Objetivo: Associar o tempo pré-hospitalar com os desfechos dos pacientes vítimas de TCE moderado e grave nos primeiros 30 dias de evolução hospitalar. Métodos: Estudo prospectivo baseado em prontuários de internação hospitalar por TCE entre julho/2021 e junho/2022 do Hospital Santa Isabel em Blumenau, Santa Catarina. Foram registrados dados gerais da internação, tempo pré-hospitalar, classificação pela escala de coma de Glasgow (ECG), achados tomográficos na admissão e evolução do paciente. Resultados: Sessenta e dois pacientes preenchiam os critérios de inclusão e foram analisados. O tempo pré-hospitalar médio foi de 91,77 minutos. Observou-se predomínio de tempos pré-hospitalares maiores em pacientes com desfechos piores (sequela neurológica ou morte) com p = 0,0006. O ECG da admissão também se relacionou com o desfecho, com piores desfechos no TCE grave (p = 0,0109). Conclusão: A análise dos resultados sugere que o ECG na admissão e o tempo pré-hospitalar têm impacto direto sobre o desfecho neurológico e mortalidade das vítimas de TCE moderado e grave.
Introduction: Traumatic brain injury (TBI) is the most prevalent trauma with the highest morbidity, mainly affecting young patients. In most cases, victims are disabled, causing permanent deficits in many of them. The search for better neurological outcomes is a constant in this trauma, with prehospital time being a possible impact variable. In this study, the prehospital time variable and its impact on neurological outcome of victims of severe and moderate TBI were analyzed. Objective: To associate prehospital time with the outcomes of patients with moderate and severe TBI in the first 30 days of hospital evolution. Methods: Prospective study based on hospital admission records for TBI from July/2021 to June/2022 at the Santa Isabel Hospital in Blumenau, Santa Catarina. General data about hospitalization, prehospital time, classification by the Glasgow Coma Scale (GCS), tomographic findings at admission and patient evolution were recorded. Results: Sixty-two patients met the inclusion criteria and were analyzed. The average prehospital time was 91.77 minutes. A predominance of longer prehospital times was observed in patients with worse outcomes (neurological deficit or death) with p = 0.0006. GCS at admission was also related to the outcome, with worse outcomes in severe TBI (p = 0, 0109). Conclusion: Analysis of the results suggests that GCS on admission and prehospital time have a direct impact on the neurological outcome and mortality of moderate and severe TBI victims.
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1 MD, MSc, Neurosurgeon, HSI; Master in Public Sciences, Professor of Neurosurgery, Foundation Regional University of Blumenau – FURB, Blumenau, SC, Brazil.
2 Medicine student, Foundation Regional University of Blumenau – FURB, Blumenau, SC, Brazil.
Received Dec 13, 2022
Accepted Jan 10, 2023
