Traumatic brain injury (TBI) is one of the most common causes of injury and death worldwide. Over the last two decades, many emergency departments have reported an increase in the number of patients who are admitted to the intensive care unit (ICU) with TBI. Because critically ill patients are at high risk for morbidity and mortality, the nature of the relationship between TBI, mortality, and ICU care merits investigation.
Over a two-year period, a group of researchers in northern China collected the hospital records of 1,645 critically ill patients who were older than 15 years when they were admitted to a Shuyang County ICU. The researchers conducted analyses of the patients’ medical information, including their Glasgow Coma Scale (GCS) scores, cause of critical illness, and mortality. They found that:
- The median GCS score was 6, indicating that a significant number of patients were categorized as lacking language and motor functions.
- The most common cause of critical illness in the ICU was intracerebral hemorrhage, a condition in which a ruptured blood vessel causes bleeding inside of the brain. Most patients who experienced this kind of hemorrhage had sustained a TBI.
- Intracerebral hemorrhages and TBI were the most common causes of mortality during the first week in the ICU, and geriatric patients were at particularly high risk of death.
To provide the highest standards of care, clinicians need to be aware of common injuries and complications that may require pharmacological or surgical intervention. As the average lifespan increases, geriatric patients – who are at higher risk for fall-related head injuries – make up a larger portion of the population and may need specialized care to prevent the morbidity and mortality associated with TBI and brain hemorrhage.
Zhou Y, Tong D, Wang S, et al. Acute spontaneous intracerebral hemorrhage and traumatic brain injury are the most common causes of critical illness in the ICU and have high early mortality. BMC Neurology. (August 2018).