Disorders of Consciousness in Patients after Craniocerebral Trauma on Individual Days of Hospitalization – Prospective Study
DOI:
https://doi.org/10.15225/PNN.2025.14.2.3Keywords
craniocerebral injuries, disorders of consciousness, Glasgow Coma ScaleAbstract
Introduction. Disorders of consciousness are states in which there is a gradual limitation of contact (of a person) with the external environment, i.e. the surroundings. In this situation, the body becomes unresponsive to external stimuli. Disorders of consciousness in traumatic brain injury can take various forms, from mild concussion with brief loss of consciousness to severe brain damage leading to coma. Symptoms may include loss of consciousness, memory impairment, headache, nausea, vomiting, dizziness, balance problems, as well as changes in behavior and mood.
Aim. The aim of the study was to analyze the influence of variables on the occurrence of consciousness disorders in patients after craniocerebral injuries in individual days of hospitalization.
Material and Methods. The study was conducted among 100 patients hospitalized in the neurotraumatology department. The prospective study employed a diagnostic survey method, utilizing measurement techniques and a questionnaire. The Glasgow Coma Scale (GCS) was used to assess the level of consciousness impairment. The results were statistically analyzed, with p<0.05 considered statistically significant. Ethics Committee approval for the study was obtained.
Results. The analysis of our own research showed that there are no statistically significant differences in the mean results of the state of consciousness (GCS) between women and men on the day of admission to the hospital (Z=0.163; p=0.163), on the 3rd day of hospitalization (Z=0.811; p=0.370), on the 7th day of hospitalization (Z=0.00; p=0.986) and on the day of discharge (Z=0.011; p=0.917). It was found that the age of patients showed a negative correlation with the GCS scale results in all examined days of hospitalization. This correlation was statistically significant (p<0.05) for all measurements except admission (p>0.05). A statistically significant difference was found in the mean scores of the state of consciousness (GCS) depending on the cause of injury on the 3rd day of hospitalization (H=3.207; p=0.016) and on the 7th day of hospitalization (H=3.390; p=0.012). No significant differences were found on the day of admission (p=0.200) or on the day of discharge (p=0.076). There are statistically significant differences in the assessment of the level of consciousness (GCS) between the group of patients with comorbidities and the group without comorbidities on the day of hospital admission (p=0.002), on the 3rd day of hospital stay (p=0.029), and on the 7th day of hospitalization (p=0.035). However, the differences are not statistically significant on the day of hospital discharge (p=0.095).
Conclusions. The disturbances of consciousness occurring in patients after craniocerebral injuries during the individual days of hospitalization significantly evolve from severe disturbances (at the beginning of hospitalization) to mild or no disturbances on the day of discharge from the ward. The factors with the greatest influence on the change in the degree of consciousness disturbances during individual days of hospitalization were the patient’s age and the presence of comorbidities. (JNNN 2025;14(2):68–75)
References
[1] Pąchalska M. Neuropsychologia kliniczna. Urazy mózgu. Tom 1, PWN, Warszawa 2014.
[2] Kołpa M., Grochowska A., Gniadek A., Jurkiewicz B. Pourazowe obrażenia czaszkowo-mózgowe u pacjentów w stanie nietrzeźwości, przyjmowanych doraźnie do szpitalnego oddziału ratunkowego. Med Og Nauk Zdr. 2016;22(1):40–45.
[3] Rymkiewicz A. Przyczyny i skutki urazów czaszkowo-mózgowych. Wsp Piel Ochr Zdr. 2014;3(2):41–46.
[4] Bialik M. Pacjent z podejrzeniem śmierci mózgu — studium przypadku. Model opieki. Mag Pielęg Położ. 2015;4:20–21.
[5] Wrona W. Charakterystyka nieprzytomności: pacjent nieprzytomny część 1. Mag Pielęg Położ. 2016;7/8:24–25.
[6] Radziwon A., Chorąży M., Wojewódzka-Żelezniakowicz M. i wsp. Analiza czynników wpływających na rokowanie w grupie pacjentów po przebytych urazach czaszkowo-mózgowych. Post Nauk Med. 2017;7:362–370.
[7] Wiśniewski K., Posmyk B.J., Bryl M. i wsp. Obrzęk mózgu u chorych po urazach czaszkowo-mózgowych. Pol Przegl Neurol. 2019;15(3):151–160.
[8] Opara J. (Red.), Urazy czaszkowo-mózgowe. Diagnostyka — leczenie — rehabilitacja. PZWL, Warszawa 2016.
[9] Teasdale G., Jennett B. Assessment of coma and impaired consciousness. A practical scale. Lancet. 1974;2(7872):81–84.
[10] Hellmann A., Tukiendorf A., Kaźmierski R. Przydatność wybranych skali klinimetrycznych w prognozowaniu ryzyka zgonu w przebiegu udaru niedokrwiennego mózgu. Neuroskop. 2010;12:57–62.
[11] Teasdale G., Maas A., Lecky F., Manley G., Stocchetti N., Murray G. The Glasgow Coma Scale at 40 years: standing the test of time. Lancet Neurol. 2014;13(8):844–854.
[12] Mehta R., Chinthapalli K. Glasgow coma scale explained. BMJ. 2019;365:l1296.
[13] Green S.M., Haukoos J.S., Schriger D.L. How to Measure the Glasgow Coma Scale. Ann Emerg Med. 2017;70(2):158–160.
[14] Kaźmierczak K., Majchrzycki M., Stryła W. Rozkład zaleconych zabiegów w rehabilitacji pacjentów po urazie czaszkowo-mózgowym w zależności od stopnia urazu wg Glasgow Coma Scale. Now Lek. 2011;80(4):288–294.
[15] Szewczak A. Ocena pacjentów opatrywanych z powodu urazu głowy w kontekście zaburzeń przewlekłych. Pielęgniarstwo w Opiece Długoterminowej. 2018;4(3):32–41.
[16] Rutkowska M. Urazy czaszkowo-mózgowe epidemią XXI wieku. Med Og. 2010;16(2):192–200.
[17] Ciechanowicz D., Samojło N., Kozłowski J., Pakulski C., Żyluk A. Przyczyny i częstotliwość zgonów z powodu urazów wielonarządowych: analiza materiału Centrum Leczenia Urazów Wielonarządowych SPSK1 w Szczecinie z 3 lat (2017–2019). Pol Przegl Chir. 2020;92(4):1–6.
[18] Baczuk L. Urazy u osób w wieku starszym. Post Nauk Med. 2008;12:793–796.
[19] Vos P.E., Diaz-Arrastia R. (Red.), Pourazowe uszkodzenie mózgu. Edra Urban & Partner, Wrocław 2017.
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