Influence of treatment factors on different stages of care on the short and longterm outcome of patients after severe traumatic brain injuries (TBI) in different age groups in Central and Eastern Europe

Between January 2001 and June 2005 the INRO collected data on 1172 patients after severe TBI in Austria, Slovakia, Bosnia, Macedonia and Croatia. We analyzed the impact of quality of care on the short and longterm outcome in different age-groups.

To assess quality of care, three scores were created. A score for treatment during the prehospital stage (PS), during hospitalization (HS) and a system factors score (SS) were created. Using these scores we analyzed the influence of the quality of care on ICU survival and 6 months outcome (defined as favorable or unfavorable based on the GOS). We divided patients into three age-groups: young (0-40), middle aged (41-60) and old (61+) and analyzed the influence of quality of care on outcomes in these groups.

The ICU survival decreased by growing age from 71% in young through 66% in middle aged to 43% in old patients. 50% of young patients had a favorable 6 month outcome compared to 40% in the middle and 13% in the old age-group.

For ICU survival a significant influence of the HS was found in all age groups (OR ranging from 1.04-1.06) and a significant effect of SS was find in young patients (OR 1.45;CI95:1.21-1.76). For the 6 month outcome no significant effect of scores was found.

Treatment procedures following the recommended guidelines can significantly increase the chance for survival after the ICU. There was no evidence on influence of the used scores on 6 months outcome.