The role of acute traumatic focal lesion on head CT scan in predicting outcome of mild traumatic brain injury patients

Background: There is a controversy regarding the examination of head CT scan in Mild Traumatic Brain Injury (mTBI) patients with a GCS score of 15. We proposed that the presence of intracranial lesion in head CT scan is more important in predicting outcome of mTBI patients regardless of GCS score. This study aimed to determine the role of intracranial lesions in mTBI patients in predicting outcome of mTBI patients. Methods: This was a prospective cohort study conducted at Sanglah Hospital Denpasar Bali. Samples of patients with a diagnosis of mTBI with GCS score 14 – 15 were recruited consecutively. Data were calculated and analyzed statistically. Results: The presence of focal lesions on head CT scan had an adjusted RR of 3.75 in determining surgery after controlling the role of GCS (< 0.001). The presence of focal lesions on head CT scan had an adjusted RR of 13.9 in predicting poor outcome after controlling the role of GCS (p < 0.012). Conclusions: The presence of acute focal lesions on head CT scan has been shown to be a significant factor affecting the outcome and the need for surgery in mTBI patients. GCS is not proven to be a factor affecting the outcome and the need for surgery in mTBI patients.