Search for a command to run...
Objetive: To analyze which clinical, laboratory, and imaging factors act as predictors of mortality due to TBI in a hospital III in northern Peru. Methods: An analytical cross-sectional study was carried out with patients admitted with a diagnosis of TBI to the José Cayetano Heredia Hospital III Piura in the period 2020-2022. The population included female and male patients over 18 years of age who were admitted to the emergency unit with a diagnosis of moderate or severe TBI and who died during hospitalization. Medical records that met the requirements for arrival time to the emergency room, Glasgow scale score, presence of comorbidities, serum sodium level, glycemia, creatinine, and computed brain tomography were included. A descriptive analysis was performed to characterize the clinical, laboratory, and imaging variables of the patients. To compare categorical variables, chi-square or Fisher exact tests were used as appropriate. For continuous variables, nonparametric tests (such as Mann-Whitney U) were used due to the lack of normality in their distribution. The results included statistical significance values (p < 0.05). The results were presented as odds ratios (OR) with 95% CI. Results: The clinical, laboratory and imaging characteristics of 144 patients diagnosed with traumatic brain injury (TBI) were analyzed. The majority of patients were male, representing 76.4% of the total, while only 20.9% were female. Regarding the type of hematoma, acute subdural hematomas were observed in 26.4%, and epidural hematomas represented 10.1%. Regarding the degree of severity of TBI, most cases were classified as mild (58.1%), followed by severe (23.6%) and moderate (16.2%) cases, according to the Glasgow scale. Patients with moderate TBI had an OR of 8,000 (95% CI: 2,481 - 25,801, p = 0.001), while those with severe TBI had an extremely high OR of 453,333 (95% CI: 52.559 - 3,910,112, p = 0.000). The analyses identified the main predictors of mortality as the presence of subarachnoid hemorrhage (OR: 21,696), hyperglycemia (OR: 6,075), hypoglycemia (OR: 10,125), and severe grades on the Marshall and Glasgow Scales. Conclusion: The study concludes that mortality associated with TBI is significantly influenced by metabolic alterations and severe clinical characteristics, which highlights the need for timely interventions and specific management strategies.