The eventual damage produced by trauma results not only from primary injury but also selleck compound from secondary injury, involving pathological mechanisms of ischaemia,

excitotoxicity, inflammation, oxidative stress, and others (Gullo et al., 2011; Hohl et al., 2012; Schwarzbold et al., 2008; Thais et al., 2012). These mechanisms reach their peak in the early phase after TBI, within hours or a day, and vary in intensity according to the genetic background, clinical features, and concomitant pathological conditions (Maas, Stocchetti, & Bullock, 2008). Long-lasting degenerations of grey and white matter, which continue over years also have been described with modern imaging techniques (Bendlin et al., 2008), together with changes in the brain’s microstructure (Sidaros et al., 2008). Several reports concerning the cognitive prognosis after TBI have emerged in the literature from retrospective convenience samples using univariate analysis and without a clear control of missing (drop out) cases (Christensen et al., 2008; Novack, Alderson, Bush, Meythaler, & Canupp, 2000). Some prospective studies investigated the cognitive recovery over time after the TBI (Bayen et al., 2012; Dikmen, Machamer, Powell, & Temkin, 2003; Sigurdardottir, Andelic, Roe, & Schanke, 2009), but the independent association among the variables

previously reported to be associated with mortality or morbidity evaluated by Glasgow Outcome Scale (Martins et al., 2009; Murray MCE公司 et al., 2007; Perel, Edwards, Wentz, & Roberts, 2006) and the cognitive prognosis remains to Gefitinib clinical trial be investigated. Our hypothesis was that variables classically associated with TBI prognosis (like Marshall CT classification, Glasgow Coma Scale [GCS], pupils examination, and admission blood glucose levels) could also be used to predict the cognitive outcome of severe TBI victims. In the present work, patients’ cognitive status was evaluated in the chronic phase (at least 1 year after the hospitalization), by administering a comprehensive and well-recognized battery of neuropsychological tests. A multivariate logistic regression analysis was carried out to investigate the independent association between

clinical, demographic, neurosurgical, laboratory, and neuroradiological variables during hospitalization and the cognitive performance of patients at least 1 year after hospitalization due to severe TBI. A total of 234 consecutive patients with severe TBI from the metropolitan region of Florianópolis city (southern Brazil), who had been admitted between February 2001 and March 2009 to the intensive care unit (ICU) of the Hospital Governador Celso Ramos were included in the acute prospective study protocol. The hospital is a tertiary referral centre for trauma for 1 million people population of the metropolitan region of Florianópolis city. Severe TBI was defined by a GCS score ≤8 after the initial stabilization treatment at the emergency room admission.