Resumen

HUANCA PANOZO, Cristhian; ESPINOZA MARQUEZ, Alejandra Natalia  y  ORTEGA MARTINEZ, Rommer Alex. Transcranial doppler and its impact on the prognosis of traumatic brain injury, Hospital Clínico Viedma, Cochabamba-Bolivia. Rev. Inv. Inf. Sal. [online]. 2023, vol.18, n.45, pp.30-39. ISSN 2075-6194.  https://doi.org/10.52428/20756208.v18i45.1037.

Introduction: Traumatic brain injury (TBI) is a major cause of death and disability; Predicting the result is useful in decision making. Transcranial Doppler (TCD) is a diagnostic tool for monitoring cerebral blood flow; establishes a reliable and early forecast. The objective is to evaluate whether the DTC is effective as a prognostic indicator. Material and methods: Prospective study of patients with TBI; DTC measurements upon admission and stay; The pulsatility index (PI) was calculated using the formula for systolic and diastolic velocity, divided by the average velocity (SV- RV/MV); intracranial hypertension was considered if the PI >1,2; The result was evaluated by the GOSE (Glasgow Outcome Scale Extended) score at 3 months (via telephone), favorable (4-5) and unfavorable (1-3). Results: 49 patients were included; the unfavorable outcome at 3 months was 63,2 %; The analysis of the group with abnormal DTC has the probability of presenting 54 times more unfavorable evolution, RR: 54; 95 % CI (8,8-32,8); p<0,0005; Sensitivity 78 %; specificity 81; AUC 0,850 and lower probability of survival at 14 days (p=0,021). Glasgow Coma Scale (ECG) close to 3 points RR: 33; 95 % CI (1,31-10,6); hypotension RR: 9,28; 95 % CI (1,49-5,7);craniectomy RR: 1,96; 95 % CI (1,01-4,41); fixed pupils RR: 3,4; 95 % CI (1,15-9,9); Marshall scale in conjunction with the ECG, greater sensitivity and specificity. Discussion: These data showed a possible effectiveness of DTC as a diagnostic and also prognostic tool in TBI.

Palabras clave : Intracranial pressure; prognosis; traumatic brain injuries; transcranial Doppler ultrasinography.