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Master Thesis

Neurodata : suivi prospectif à un an d'une cohorte de traumatisés crâniens admis en réanimation au CHU de Caen

Abstract : Introduction: there are few French epidemiological studies since the evolution of recommendations concerning the management of head trauma. The age and mechanism of accidents have changed in recent years. Material and methods: this is a monocentric prospective observational study carried out after favorable opinion of the committee for the protection of persons. Patients were included from the beginning of the intra-hospital care. The prognosis was favorable if the GOS-Extended score at one year of the trauma was greater than 4. Results: between November 2015 and December 2017, 166 patients were included. 51% of patients had GCS <8. The initial Glasgow score was 11 [6; 14] in the "favorable outcome" category vs. 6 [3; 11] in the "adverse outcome" category (p <.001). At one year, 36% of patients had died, 1% of patients were vegetative, 12% had severe disability, 17% had moderate disability and 31% had good recovery. 4% of patients were lost to follow-up. The median GOS-E is 7 [6; 8] vs 1 [1; 2] (p <0.001). Age (OR 1,04), no addiction (OR 0,21), Glasgow score (OR 0,84), bilateral mydriasis (OR 7,63), and Marshall score at IV (OR 18,25) are factors correlated with the neurological prognosis. Conclusion: these data show a mortality of 36% at one year with persistence of physical handicap and heavy cognitive (nearly 30%) in spite of the evolution of the care. This can help guide professionals in their decision-making, their therapeutic management and finally inform patients and their families.
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Master Thesis
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Alexandra Counilh. Neurodata : suivi prospectif à un an d'une cohorte de traumatisés crâniens admis en réanimation au CHU de Caen. Médecine humaine et pathologie. 2019. ⟨dumas-02302449⟩



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