Predictors of Neurosurgical Outcomes in Traumatic Brain Injury: A Study from Banda Aceh, Indonesia
Abstract
Introduction: Traumatic brain injury (TBI) remains a major global health challenge and frequently requires neurosurgical intervention. Various clinical, surgical, and systemic factors may influence postoperative morbidity and mortality. This study aimed to identify key predictors of postoperative outcomes in patients with TBI undergoing neurosurgical procedures.
Subject and Method: A prospective cohort study was conducted at Dr. Zainoel Abidin General Hospital in Banda Aceh from July to October 2024, involving 48 TBI patients who were selected through total sampling. Statistical analysis using chi-square tests and multiple logistic regression identified significant predictors.
Results: We enrolled 48 patients, with an overall postoperative morbidity rate at 58.3%, and the mortality rate was 22.9%. Morbidity was significantly associated with preoperative GCS score (p=0.001), injury-to-surgery time (p=0.039), respiratory (p=0.007), and cardiovascular system (p=0.001). Mortality was significantly associated with preoperative GCS score (p=0.002), surgery duration (p=0.041), respiratory (p=0.041), and cardiovascular system (p=0.004). Multivariate analysis confirmed the preoperative GCS score was the most significant predictor of both morbidity and mortality (p<0.05).
Conclusion: A low preoperative GCS score is a strong predictor of poor postoperative outcomes in patients with TBI. Optimizing perioperative management may improve clinical outcomes in TBI patients undergoing neurosurgical intervention
Keywords
Full Text:
PDFReferences
Magnusson BM, Koskinen LOD. Classification and characterization of traumatic brain injuries in the Northern Region of Sweden. J Clin Med. 2023;13(8): 1–16. Doi: 10.3390/jcm13010008.
I R Maas A, Menon DK, Manley GT, Abrams M, Åkerlund C, Andelic N, et al. Traumatic brain injury: progress and challenges in prevention, clinical care, and research A. Lancet Neurol. 2022;21(11):1004–60. Doi: 10.1016/S1474-4422(22)00309-X.
Theadom A. Traumatic brain injury. Cambridge Handbook of Psychology, Health and Medicine: 3rd Ed. 2019, 157–164.
Haarbauer-Krupa J, Pugh MJ, Prager EM, Harmon N, Wolfe J, Yaffe K. Epidemiology of chronic effects of traumatic brain injury. J Neurotrauma. 2021;38(23):3235–247. Doi: 10.1089/neu.2021.0062.
Yue JK, Etemad LL, Elguindy MM, van Essen TA, Belton PJ, Nelson LD, et al. Prior traumatic brain injury is a risk factor for in-hospital mortality in moderate to severe traumatic brain injury: a TRACK-TBI cohort study. Trauma Surg Acute Care Open. 2024;9(1):1–10. Doi: 10.1136/tsaco-2024-001501
Okidi R, Ogwang DM, Okello TR, Ezati D, Kyegombe W, Nyeko D, et al. Factors affecting mortality after traumatic brain injury in a resource-poor setting. BJS Open. 2020;4(2):320–5. Doi: 10.1002/bjs5.50243
Breeding T, Martinez B, Katz J, Nasef H, Santos RG, Zito T, et al. The association between gender and clinical outcomes in patients with moderate to severe traumatic brain injury: a systematic review and meta-analysis. J Surg Res. 2024;295:791–9. Doi: https://doi.org/10.1016/j.jss.2023.11.035.
Koome G, Thuita F, Egondi T, Atela M. Association between traumatic brain injury (TBI) patterns and mortality: a retrospective case-control study. F1000Research. 2022;10(795):1–20. Doi; 10.12688/f1000research.54658.2.
Martaria N, Rachman IA, Prihatno MR. Pengelolaan anestesi untuk cedera otak traumatik pada pasien dengan stroke iskemik. J Neuroanestesi Indones. 2019;8(3):168–79. Doi: 10.24244/jni.v8i3.235.
Skaansar O, Tverdal C, Rønning PA, Skogen K, Brommeland T, Røise O, et al. Traumatic brain injury—the effects of patient age on treatment intensity and mortality. BMC Neurol. 2020;20(1):1–10. Doi: 10.1186/s12883-020-01943-6.
Basak D, Chatterjee S, Attergrim J, Sharma MR, Soni KD, Verma S, et al. Glasgow coma scale compared to other trauma scores in discriminating in-hospital mortality of traumatic brain injury patients admitted to urban Indian hospitals: A multicentre prospective cohort study. Injury [Internet]. 2023;54(1):93–9. Available from: https://doi.org/10.1016/j.injury.2022.09.035.
Iyanna N, Donohue JK, Lorence JM, Guyette FX, Gimbel E, Brown JB, et al. Early glasgow coma scale score and prediction of traumatic brain injury: a secondary analysis of three harmonized prehospital randomized clinical trials. Prehospital Emerg Care [Internet]. 2024;0(0):1–9. Available from: https://doi.org/10.1080/10903127.2024.2381048.
Salottolo K, Ripul Panchal RMM, Dhakal L, William Rosenberg, Kaysie L Banton, David Hamilton DB-O. Incorporating age improves the Glasgow Coma Scale score for predicting mortality from traumatic brain injury. Trauma Surg Acute Care Open. 2020;6:1–7. Doi: 10.1136/tsaco-2020-000641
Turfa J, Hijazi A, Fadlallah Y, El-Harati M, Dimassi H, Najjar M El. Predictors of 30-Day Mortality and Morbidity Following Craniotomy for Traumatic Brain Injury: An ACS NSQIP Database Analysis. Neurotrauma reports. 2024;5(1):660–70. Doi: 10.1089/neur.2024.0039.
Zaky Ma’arif A, Nugraha C, Pudji A. Bed measuring estimate blood volume and cardiac output with tft display equipped with data storage (SpO 2 and BPM). Ijeemi. 2020;2(1):6–12. Doi; 10.35882/ijeeemi.v2i1.2.
Goubert R, Wray A, Matonis D. A Case Report of Epidural Hematoma After Traumatic Brain Injury. J Educ Teach Emerg Med. 2020;5(3):V22–V24. Doi: 10.21980/J8R059.
Yasa IMWDP, Golden N, Niryana IW. Faktor-faktor yang berhubungan dengan tindakan operasi pada pasien cedera kepala ringan dan cedera kepala sedang di RSUP Sanglah Denpasar periode Januari-Desember 2017. Medicina (B Aires). 2019;50(1):174–9. Doi: 10.15562/medicina.v50i1.471.
Carney N, Totten AM, O’Reilly C, Ullman JS, Hawryluk GWJ, Bell MJ, et al. Guidelines for the Management of Severe Traumatic Brain Injury, Fourth Edition. Neurosurgery. 2017;80(1):6–15. Doi: 10.1227/NEU.0000000000001432
Marhold F, Prihoda R, Pruckner P, Eder V, Glechner A, Klerings I, Gombos J, Popadic B, Antoni A, Sherif C, Scheichel F. The importance of additional intracranial injuries in epidural hematomas: detailed clinical analysis, long-term outcome, and literature review in surgically managed epidural hematomas. Front Surg. 2023;10:1–12. Doi:10.3389/fsurg.2023.1188861.
Chandra J, Tobing WL. Risk factors of mortality due to traumatic brain injury in Marsidi Judono general hospital, Belitung, Indonesia. Indonesian J Neurosurg. 2021;4(3):106–11. Doi: 10.15562/ijn.v4i3.163
DOI: https://doi.org/10.24244/jni.v15i1.750
Refbacks
- There are currently no refbacks.

JNIis licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License










