Relationship between CT-Scan Findings and Longitudinal Blood Markers with the Occurrence of Death among Comatose Patients Due to Traumatic Brain Injury: Retrospective Longitudinal Study

Background Objective: Blood markers and CT-scan results can be useful to the prognosis outcome of traumatic brain injury (TBI). This study aims to evaluate and compare markers and CT-scans during hospitalization regarding death and recovery as the outcomes. Materials Methods: This longitudinal-observational retrospective study was performed on 133 patients with comatose caused by head trauma from admission to death/discharge in Shohada-E-Tajrish Hospital in Tehran during 2018-2020. The follow-up period lasted 15 days. The patients’ demographic and CT-scans were measured on admission. Blood markers were measured daily. Vital signs and GCS were collected every six hours. These variables were compared in survivor and non-survivor groups. Results: Death occurred for 78 patients (58.64%). Tachycardia (OR=60.1, P=0.003), SDH (OR=39.3, P 0.001) ICH (OR=9.91, P 0.001), SAH (OR=13.6, P 0.001) had a significant relationship to death on multivariate logistic regression. The mean TT, PT, INR, GCS, PR, and systolic and diastolic blood pressure at the beginning of hospitalization were significantly different in the surviving and non-surviving groups. GCS, Cr, BUN, PTT, PT, INR, FBS, and PH had separate lines with spacing without overlap in the two groups in the graphs during hospitalization. Conclusion: Based on the results, the factors such as age, tachycardia, and some CT-scan findings (SAH, ICH, and SDH), as well as high coagulation profile (INR, PTT) and low GCS on admission, were important variables to the prognosis of TBI patients. During hospitalization, high values of BUN, PR, Cr, FBS, PT, and INR and low values of GCS, RR, and PH were associated with a worthwhile outcome. In addition, high changes in BUN, GCS, RR, PR, and BP during hospitalization should be considered a worthwhile prognosis.