DOI: https://doi.org/10.22263/2312-4156.2025.4.33
V.V. Hancharou1,2
Risk factors associated with unfavorable outcome in patients with severe traumatic brain injury
1Minsk City Clinical Emergency Hospital, Minsk, Republic of Belarus
2Belarusian State Medical University, Minsk, Republic of Belarus
Vestnik VGMU. 2025;24(4):33-41.
Abstract.
Traumatic brain injury (TBI) remains one of the leading causes of mortality and disability.
Objectives. To identify key risk factors for unfavorable outcome in patients with severe TBI.
Material and methods. The prospective study was conducted in the ICU (for neurosurgical patients) of the Minsk City Clinical Emergency Hospital from 2017 to 2024 years on the impact of potential risk factors on trauma outcomes. 116 patients with severe TBI were included in it.
Results. The age of patients with the unfavorable outcome was 50,00 [37,75; 60,00] and 38,00 [34,00; 56,00] years in case of the favorable outcome (p=0,0478). The volume of transfusion for 14 days in the ICU in patients with the unfavorable outcome was 2360,00 [1082,50; 4857,50] ml versus 1120,00 [50,00; 2280,00] ml in case of the favorable outcome (p=0,0006). While proving nutritional support the protein value of ≥1.5 g protein/kg/day was in 63,6% of patients with an unfavorable outcome compared to 38,4% with a favorable outcome (p=0,0158). 80,2% of patients (n=93) had complications and only 63,8% of patients (n=74) had multiple complications (≥2). Pneumonia was present in 69,0% cases (n=74), pulmonary embolism – in 41,4% (n=48), MOF (multiple organ failure) – in 24,1% (n=28), meningitis and sepsis – in 12,1% of cases each (n=14).
Conclusions. The risk factors were identified: the age over 40 years (RR=1,53; p=0,0099), transfusion volume >2300 ml (RR=1.43; p=0,0099), protein part of nutrition support <1.5 g protein/kg/day (RR=1,42; p=0,0158) and presence of complications (RR=39,57; p=0,0086): pneumonia (RR=11,10; p<0,0001), pulmonary embolism (RR=2,22; p<0,0001), MOF (RR=1,70; p<0,0001), meningitis and sepsis (RR=1,48; p=0,0002).
Keywords: severe TBI, risk factors, age, nutritional support, blood transfusion, complications, pneumonia, multiple organ failure.
Acknowledgments. To Svetlitskaya Olga Ivanovna for the supervision, Komlikov Sergey Yuryevich, Bogdan Irina Leonidovna, Lizun Evgeny Vladimirovich for assisting in the research material collecting, the anonymous reviewer for reading and recommendations left for the article.
The source of funding. The work was carried out within the framework of the initiative research work “Nutritional support of patients in a critical state” (State registration number 20192185 dated 23.08.2019), as well as a grant from the President of the Republic of Belarus in science, education, healthcare and culture for 2024 (the Order of the President of the Republic of Belarus dated January 3, 2024 No. 4gr “On the provision of grants from the President of the Republic of Belarus for 2024”).
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Submitted 30.06.2025
Accepted 22.08.2025
Information about authors:
Viachaslau V. Hancharou – anesthesiologist-resuscitator of the department of resuscitation and intensive care for patients of the neurosurgical profile, Minsk City Clinical Emergency Hospital; lecturer of the Chair of Anesthesiology and Resuscitation with a Course of advanced training and retraining, Belarusian State Medical University, https://orcid.org/0009-0002-5854-6033, e-mail: Этот адрес электронной почты защищён от спам-ботов. У вас должен быть включен JavaScript для просмотра..
