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Revista Archivo Médico de Camagüey

versión On-line ISSN 1025-0255


VARELA HERNANDEZ, Ariel et al. Prognosis of significant tomographic worsening in patients with cranio-encephalic traumatism. AMC [online]. 2013, vol.17, n.5, pp.531-543. ISSN 1025-0255.

Background: the carrying out of the structural imaging study of the brain through a sequential computerized tomography of brain is an established practice although it is conducted in a heterogeneous way in different contexts since there does not exist all the evidence necessary to set the standards. Objective:  to determine the predictive factors of significant tomographic change in patients with cranio-encephalic traumatism. Method: a quasi-experimental study was conducted with all the cranial-injured patients who had been studied at least twice during the same hospitalization period through a computerized tomography of brain. The systematization of the orders of the sequential tomography, its application, and afterwards the evaluation of the behavior of the variables through an exploratory statistic, the X2 test, ANOVA, and logistic regression, were made. Results: eighty-four patients were studied and the 16.7 % of the sample showed significant tomographic changes in the sequential studies. The patients group that presented persistent symptoms with initial Marshall III or IV was more related to these changes. The main variables involved in the prognosis were the high-speed mechanisms in the appearance of the traumatism, the persistent symptoms, and the initial Rotterdam score. Conclusions: when applying the protocol for the carrying out of the sequential computerized tomography of brain in these patients it is really important to take into consideration the persistence of the symptoms of the patients, the increase of the Rotterdam score in the initial tomography, and if the mechanism of appearance was a high-speed one or not.


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