Registration of the epidemiological and cunctional clinical profile of patients post traumatic brain injury at a high complexity hospital in the interior of the state of São Paulo
DOI:
https://doi.org/10.11606/issn.1679-9836.v105i2e-241802Keywords:
TBI, Functional Prognosis, Glasgow Coma Scale, NOS-TBIAbstract
Traumatic Brain Injury (TBI) results from physical forces that cause brain lesions and functional impairment. Although the Glasgow Coma Scale (GCS) is widely used, it fails to capture all neurological deficits, leading to the development of the Neurological Outcome Scale for Traumatic Brain Injury (NOS-TBI), based on the NIHSS and designed to assess post-TBI sequelae. This prospective study aimed to create a clinical registry of TBI cases at FSCMF (Franca, São Paulo, Brazil), characterize the clinical and functional profile of patients, and analyze predictive factors for six-month outcomes. Adults with TBI admitted between October 2023 and December 2024 were included. Clinical assessments were conducted at admission, during hospitalization, and six months after discharge using the GCS, NOS-TBI, TICS-M, Modified Rankin Scale, and Edinburgh Handedness Inventory. The final sample consisted of 40 patients, predominantly male (72.5%), with a median age of 51 years. The main causes of TBI were traffic accidents (44.7%) and falls (31.6%). Regarding severity, 70% had mild TBI, 12.5% moderate, and 17.5% severe. The NOS-TBI demonstrated excellent internal consistency (α>0.9) and high interrater reliability (K>0.8), with perfect agreement in some items (K=1). Despite the strong reliability of the scale, only nine patients completed the six-month follow-up, limiting the analysis of functional outcomes. Most showed satisfactory recovery, although severe TBI, older age, and high-impact trauma mechanisms were associated with poorer prognosis. This study reinforces the utility of the NOS-TBI as a sensitive tool for early identification of neurological deficits and as a complement to the GCS. Difficulties in patient follow-up highlight the need to improve post-discharge tracking strategies and strengthen the integration of care within the Brazilian Unified Health System (SUS).
Downloads
References
1. David CA. Traumatismo cerebral. In: Jones HR, editor. Neurologia de Netter. Porto Alegre: Artmed; 2006. p. 672–85.
2. Neto OMP. Traumatismo crânio encefálico. Ribeirão Preto; 2007 [Internet]. https://edisciplinas.usp.br/pluginfile.php/3145682/mod_resource/content/1/TCE.pdf. Acesso em: 19 abr. 2019.
3. Costa CDS, Scarpelini S. Avaliação da qualidade do atendimento ao traumatizado através do estudo das mortes em um hospital terciário. Rev Col Bras Cir. 2012;39(4):249–54. Doi:10.1590/S0100-69912012000400002.
4. Moore EE, Mattox KL, Feliciano DV. Manual do trauma. 4ª ed. Porto Alegre: Artmed; 2006. 646 p.
5. Winn HR, Bullock M, Hovda D, Shahlaie K, Zwienenberg-Lee M, Muizelaar J, et al. Clinical pathophysiology of traumatic brain injury. In: Youmans neurological surgery. 4th ed. Philadelphia: Elsevier Saunders; 2011. p. 3362–79.
6. Graham DI, McIntosh TK, Maxwell WL, Nicoll JA. Recent advances in neurotrauma. J Neuropathol Exp Neurol. 2000;59(8):641-51. Doi: 10.1093/jnen/59.8.641.
7. McConnell KJ, Newgard CD, Mullins RJ, Arthur M, Hedges JR. Mortality benefit of transfer to level I versus level II trauma centers for head-injured patients. Health Serv Res. 2005;40(2):435-57. Doi: 10.1111/j.1475-6773.2005.00366.x.
8. Mascarenhas MDM, Monteiro RA, Sa NNB, Gonzaga LAA.; Neves ACM, Silva M. MA. Epidemiologia das causas externas no Brasil: morbidade por acidentes e violências. In: Brasil. Ministério da Saúde (MS). Secretaria de Vigilância em Saúde. Departamento de Análise de Situação em Saúde. Saúde Brasil 2010: uma análise da situação de saúde e de evidências selecionadas de impacto de ações de vigilância em saúde. Brasília: MS; 2011.
9. Keane JR, Baloh RW. Posttraumatic cranial neuropathies. Neurol Clin. 1992;10(4):849-67. PMID: 1435660.
10. Murali R, Rovit RL. Injuries of the cranial nerves. In: Cooper PR, Golfinos JG, editors. Head injury. New York: McGraw-Hill; 2000. p. 201–20.
11. Dorneles e Silva G, Siqueira MJS, Alvarenga LR. Arquivo pessoal. 2024.
12. Tokuno T, Nakazawa K, Yoshida S, Matsumoto S, Shingu T, Sato S, et al. Primary oculomotor nerve palsy due to head injury: analysis of 10 cases. No Shinkei Geka. 1995;23(6):497-501. PMID: 7609832.
13. Podoshin L, Fradis M. Hearing loss after head injury. Arch Otolaryngol. 1975;101(1):15–8. Doi: 10.1001/archotol.1975.00780300019004
14. Teasdale G, Mathew P. Mechanisms of cerebral concussion, contusion and others effects of head injury. In: Youmans JR, editor. Neurological surgery. 4th ed. Philadelphia: WB Saunders; 1996. p. 1533–48.
15. Weber KT. Registro de traumatismo cranioencefálico de Ribeirão Preto (ReTER): validação do instrumento Neurological Outcomes Scale for Traumatic Brain Injury (NOS-TBI) e estudo coorte prospectivo [tese]. Ribeirão Preto: Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo; 2019.
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Leonardo Ribela de Alvarenga, Mariana de Oliveira Lima, Giovanna Dorneles e Silva, Maria Júlia Sindou Siqueira

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.