Frontal Sinus Fractures and Traumatic Brain Injury: Predictors of Mortality in Surgical Management

Study design: This is anobservational, retrospective, analytical study.

Objective: The aim was todetermine a statistical basis for a future line of research based on the epidemiology of a center located in a developing country, as well as defining indirect mortality predictors.

Methods: Clinical files were reviewed based on diagnosis of Traumatic Brain Injury (TBI), according to the International Classification of Diseases 10th Revision (ICD-10). Sociodemographic variables as well as treatment modality of the condition during hospitalization was recorded. The patient sample was divided into two groups. Student's T-test was performed in variables with normal distribution and Chi-square test in independent random variables with standard normal distribution. For correlations, Pearson's correlation coefficient was used, taking the P-value <.05 as statistically significant.

Results: A total of 150 participants were included in this study, from which 125 were male (83.3%). The average age was 28.58 ± 16.55 years. The median hospitalization time was 9 days. Forty-five patients (30%) were treated conservatively. Fifteen patients died during hospitalization. The factors considered as predictors of mortality in the general population corresponded to Motor Vehicle Accident, Frontonasal Duct Obstruction, Neuroinfection, Glasgow Coma Scale (GCS) at admission, as well as GCS at discharge. In the patients who underwent surgery, predictors of mortality corresponded to Motor Vehicle Accident, Bilateral Frontal Craniotomy, Surgical Bleeding >475 cc, Neuroinfection, as well as GCS at admission and discharge.

Conclusions: The creation of adequate diagnostic and therapeutic algorithms in traumatic brain injury management is needed, especially in developing countries. More specific studies are needed, particularly analytical and multicentric studies, which may allow the development of these algorithms.