Article

OBJECTIVE: To systematically review which determinants, assessed within the first
month after a moderate to severe traumatic brain injury, predict 6-month
functional outcome. METHODS: Databases were searched for relevant publications
between 1995 and August 2008. Selection criteria were: prospective cohort
studies; determinants associated with functional outcome 6 months after moderate
to severe traumatic brain injury in adult patients; determinants assessed within
the first month post-injury. Two reviewers independently performed the selection
and quality assessment. A best- evidence synthesis was performed for prognostic
factors assessed in 2 or more studies. RESULTS: Twenty-eight studies were
included, 27 of which were high quality. Most studies used the Glasgow Outcome
Score at 6 months post-injury as outcome measure, sometimes in combination with
other outcome measures. Strong evidence for predicting outcome at 6 months was
found for the Glasgow Coma Scale (GCS), GCS admission, motor score, midline shift
on computed tomography scan, subdural haematoma and pulsatility index. Strong
evidence of no association was found for gender and intraventricular haemorrhage.
For other determinants, inconclusive or no evidence was found. CONCLUSION: GCS, GCS on admission, motor score, midline shift, subdural haematoma and pulsatility
index predicted outcome 6 months after traumatic brain injury. Gender and
intraventricular haemorrhage did not have predictive value.

Langue : ANGLAIS