Predicting Prognosis of Isolated Head Injury: A Computer-Based Model with Simple Variables
Predicting Prognosis of Isolated Head Injury: A Computer-Based Model with Simple Variables
Objective: Over one hundred predictive models were defined in the past for head injury (HI) prognosis, but none of them have been widely used up to the present. The aim of this study is to predict the prognosis of isolated HI patients by simply using data from the first day after injury. Materials and Methods: Data of head injury patients in Trakya University Hospital between January 1996 and December 2006 were obtained from records. The age, gender, causes of HI, basic neurologic examination findings, radiologic findings and discharge status are examined. Results: Most of the data were simplified as absent (0) and present (1), and mortality rates for each groups were accepted weighted values. All data were processed statistically and two models were created. Model 1 with Glasgow Coma Scale (GCS) score predicted the mortality/vegetative event at a rate of 56.5%, and the conscious survival event at 98.7%. Model 2, without the GCS score, predicted the mortality/vegetative event at 55.1% rate and the conscious survival event at 99.2%. Conclusion: Both models could be used for informing the patient and relatives and helping them to understand the severity of HI in busy working conditions of emergency departments.
___
- Signorini DF, Andrews PJ, Jones PA, Wardlaw JM, Miller JD. Predict- ing survival using simple clinical variables: a case study in traumatic brain injury. J Neurol Neurosurg Psychiatry 1999;66:20-5. [CrossRef]
- Koskinen S, Alaranta H. Traumatic brain injury in Finland 1991-2005: a nationwide register study of hospitalized and fatal TBI. Brain Inj 2008;22:205-14. [CrossRef]
- Schaan M, Jaksche H, Boszczyk B. Predictors of outcome in head injury: proposal of a new scaling system. J Trauma 2002;52:667-74. [CrossRef]
- Udekwu P, Kromhout-Schiro S, Vaslef S, Baker C, Oller D. Glasgow Coma Scale score, mortality, and functional outcome in head-in- jured patients. J Trauma 2004;56:1084-9. [CrossRef]
- Wardlaw JM, Easton VJ, Statham P. Which CT features help pre- dict outcome after head injury? J Neurol Neurosurg Psychiatry 2002;72:188-92. [CrossRef]
- Hukkelhoven CW, Steyerberg EW, Habbema JD, Farace E, Marmarou A, Murray GD, et al. Predicting outcome after trau- matic brain injury: development and validation of a prognos- tic score based on admission characteristics. J Neurotrauma 2005;22:1025-39. [CrossRef]
- Hernández AV, Steyerberg EW, Butcher I, Mushkudiani N, Taylor GS, Murray GD, et al. Adjustment for strong predictors of outcome in traumatic brain injury trials: 25% reduction in sample size require- ments in the IMPACT study. J Neurotrauma 2006;23:1295-303. [CrossRef]
- Steyerberg EW, Mushkudiani N, Perel P, Butcher I, Lu J, McHugh GS, et al. Predicting outcome after traumatic brain injury: develop- ment and international validation of prognostic scores based on ad- mission characteristics. PLoS Med 2008;5:e165. [CrossRef]
- Mushkudiani NA, Engel DC, Steyerberg EW, Butcher I, Lu J, Marma- rou A, et al. Prognostic value of demographic characteristics in trau- matic brain injury: results from the IMPACT study. J Neurotrauma 2007;24:259-69. [CrossRef]
- Butcher I, McHugh GS, Lu J, Steyerberg EW, Hernández AV, Mushkudiani NA, et al. Prognostic value of cause of injury in trau- matic brain injury: results from the IMPACT study. J Neurotrauma 2007;24:281-6. [CrossRef]
- Marmarou A, Lu J, Butcher I, McHugh GS, Murray GD, Steyerberg EW, et al. Prognostic value of the Glasgow Coma Scale and pu- pil reactivity in traumatic brain injury assessed pre-hospital and on enrollment: an IMPACT analysis. J Neurotrauma 2007;24:270-80. [CrossRef]
- Maas AI, Steyerberg EW, Butcher I, Dammers R, Lu J, Marmarou A, et al. Prognostic value of computerized tomography scan charac- teristics in traumatic brain injury: results from the IMPACT study. J Neurotrauma 2007;24:303-14. [CrossRef]
- Van Beek JGM, Mushkudiani NA, Steyerberg EW, Butcher I, McHugh GS, Lu J, et al. Prognostic value of admission laboratory parameters in traumatic brain injury: results from the IMPACT study. J Neurotrauma 2007;24:315-28. [CrossRef]
- Butcher I, Maas AI, Lu J, Marmarou A, Murray GD, Mushkudiani NA, et al. Prognostic value of admission blood pressure in trau- matic brain injury: results from the IMPACT study. J Neurotrauma 2007;24:294-302. [CrossRef]
- Perel P, Edwards P, Wentz R, Roberts I. Systematic review of prog- nostic models in traumatic brain injury. BMC Med Inform Decis Mak 2006;6:38. [CrossRef]
- Demetriades D, Kuncir E, Brown CVR, Martin M, Salim A, Rhee P, et al. Early prediction of mortality in isolated head injury patiens: A new predictive model. J Trauma 2006;61:868-72. [CrossRef]
- Dawson-Saunders B, Trapp RG. Basic and Clinical Biostatistics, 2nd ed, Norwalk, CT: Appleton & Lange, 1993.
- Xu XY, Liu WG, Yang XF, Li LQ. Evaluation of models that predict short-term outcome after traumatic brain injury. Brain Injury June 2007;21:575-82. [CrossRef]
- Ottochian M, Benfield R, Inaba K, Chan LS, Demetriades D. Pro- spective evaluation of a predictive model of mortality in patients with isolated head injury. J Trauma 2009;67:81-4. [CrossRef]
- Murray LS, Teasdale GM, Murray GD, Jennett B, Miller JD, Pickard JD, et al. Does prediction of outcome alter patient management? Lancet 1993;341:1487-91. [CrossRef]