Análise da gravidade dos traumatismos cranioencefálicos em pacientes atendidos em um hospital terciário

Abstract

Background: Traumatic brain injury (TBI) is a lesion caused by external forces, such as impacts, falls, or collisions, which affect the brain and cranial structures. Its severity can be mild, moderate, or severe, and classification is generally based on clinical signs and the Glasgow Coma Scale (GCS). An in-depth study of this topic is urgent due to the high morbidity and mortality rates of patients affected by this condition in Brazil, primarily involving young, economically active adults. This makes the problem not only a public health issue but also a factor that impacts the country's socioeconomic development. Objective: To outline the clinical-epidemiological profile and analyze the outcomes associated with the neurological severity of patients with TBI, as determined by the Glasgow Coma Scale (GCS) at admission, in a referral hospital in northern Rio Grande do Sul. Methods: This is a retrospective cohort study that included patients admitted for TBI at the Hospital de Clínicas de Passo Fundo in 2024. Data were collected from electronic medical records, and the statistical analysis consisted of characterizing the sample and verifying the relationship between variables using Fisher's Exact Test (α=0.05), in addition to calculating the Years of Life Lost (YLL) for deaths. Results: In the sample of 103 patients, there was a predominance of males (64.4%), individuals under 60 years of age (80.8%), and economically active individuals (60.6%). Falls were the main mechanism of injury (56.3%), followed by traffic accidents (22.3%). Mild TBI accounted for 70.9% of the cases, with a 97.1% hospital discharge rate. Neurological severity was related to the need for intensive care (p<0.001), mortality (p<0.001), and a length of hospital stay greater than 1 day (p=0.005). Moderate-to-severe TBI showed higher ICU admission and mortality rates. The three recorded deaths totaled 59.20 Years of Life Lost. Conclusion: Initial neurological severity showed significant prognostic value in risk stratification and the allocation of hospital resources for patients with TBI.