Amnésia pós-traumática: fatores relacionados e qualidade de vida pós-trauma / Post-traumatic amnesia: points related and post- traumatic quality of life
AUTOR(ES)
Silvia Cristina Fürbringer e Silva
DATA DE PUBLICAÇÃO
2008
RESUMO
The closed traumatic brain injury (CTBI) is usually followed by a post-traumatic amnesia (PTA) period, important indicative of gravity to this kind of trauma and used to decisions for rehabilitation of the victims. Considering difficulties to establish the permanence of PTA in the available literature, as well as lack of knowledge of this Sindrome, this study had as main objectives: identify main points related to PTA of long term (>24 hours) for CTBI victims during the hard period of trauma, compare victimsquality of life for those who presented long term with those who doesn´t, and analysis the relationship between quality of life and PTA period, being the patients or not, in coma period. This is a quantitative study that was made using prospective, longitudinal and correlational approach, using data from both main intense phase of the treatment (pos trauma hospitalization) and quality of life valuation considered 3 to 6 months after the traumatic event. It was aim of this research 187 CTBI victims, with their age superior of 14 years old, with no demency diagnosis before the event or TBI, all attended by the emergency of a Refence hospital for trauma patients in São Paulo city, in their first 12 hours after the trauma and interned in this same hospital in the period of December 2006 and October 2007. The independent variables analysed to identify association points for the long term PTA was age, sex, brain encephalic trauma gravity, local and lesion kind, number of encephalic lesion diangosticated and medicament with action in the central neurologic system used or corticoids. The main patients were male (86.2%), victims from traffic accidents (58.3%), with indication of mild CTBI by GCS (61.5%). Age media of 38 years old (± 16.81), PTA period was 7.8 days (±12.2), including coma period and 5.0 days (±6.7), without including this period. Points associated with long term PTA, identified by logistic regression model adjusted by the variable of the lesion area (intra/extra axial), was: GCS initial <= 12 (OR= 20.17) AIS/head >=3 (OR= 2.80) and use of Fenitoin (OR= 2.60), Midazolan (OR=2.83) or both drugs (OR= 3.83). When compared to quality of life of the victims that presented PTA long and short term, it is seen significant difference in the groups observing domain, functional capacity, limitation for physical and social activities from the SF-36 Health Survey (SF-36). The group with long term PTA has presented worst results than the short term in these three domains. The related analysis made between domain of SF-36 and PTA time (duration) considering or not coma period of time has indicated that the measure of time from PTA must exclude coma period, as well as the studies and correlations were much more expressive when this measure of PTA was used
ASSUNTO(S)
amnésia amnesia cranioencephalic cranioencefálico traumatic brain injury traumatismos encefálicos quality of life qualidade de vida
