BACKGROUND: Prediction of outcome after traumatic brain injury (TBI) remains elusive. We tested the use of a single hospital Glasgow Coma Scale (GCS) Score, GCS Motor Score, and the Head component of the Abbreviated Injury Scale (AIS) Score to predict 2-week cumulative mortality in a large cohort of TBI patients admitted to the eight U.S. Level I trauma centers in the TBI Clinical Trials Network. METHODS: Data on 2,808 TBI patients were entered into a centralized database. These TBI patients were categorized as severe (GCS score, 3-8), moderate (9-12), or complicated mild (13-15 with positive computed tomography findings). Intubation and chemical paralysis were recorded. The cumulative incidence of mortality in the first 2 weeks after head injury was calculated using Kaplan-Meier survival analysis. Cox proportional hazards regression was used to estimate the magnitude of the risk for 2-week mortality. RESULTS: Two-week cumulative mortality was independently predicted by GCS, GCS Motor Score, and Head AIS. GCS Severity Category and GCS Motor Score were stronger predictors of 2-week mortality than Head AIS. There was also an independent effect of age (<60 vs. ≥60) on mortality after controlling for both GCS and Head AIS Scores. CONCLUSIONS: Anatomic and physiologic scales are useful in the prediction of mortality after TBI. We did not demonstrate any added benefit to combining the total GCS or GCS Motor Scores with the Head AIS Score in the short-term prediction of death after TBI.
BACKGROUND: Prediction of outcome after traumatic brain injury (TBI) remains elusive. We tested the use of a single hospital Glasgow Coma Scale (GCS) Score, GCS Motor Score, and the Head component of the Abbreviated Injury Scale (AIS) Score to predict 2-week cumulative mortality in a large cohort of TBI patients admitted to the eight U.S. Level I trauma centers in the TBI Clinical Trials Network. METHODS: Data on 2,808 TBI patients were entered into a centralized database. These TBI patients were categorized as severe (GCS score, 3-8), moderate (9-12), or complicated mild (13-15 with positive computed tomography findings). Intubation and chemical paralysis were recorded. The cumulative incidence of mortality in the first 2 weeks after head injury was calculated using Kaplan-Meier survival analysis. Cox proportional hazards regression was used to estimate the magnitude of the risk for 2-week mortality. RESULTS: Two-week cumulative mortality was independently predicted by GCS, GCS Motor Score, and Head AIS. GCS Severity Category and GCS Motor Score were stronger predictors of 2-week mortality than Head AIS. There was also an independent effect of age (<60 vs. ≥60) on mortality after controlling for both GCS and Head AIS Scores. CONCLUSIONS: Anatomic and physiologic scales are useful in the prediction of mortality after TBI. We did not demonstrate any added benefit to combining the total GCS or GCS Motor Scores with the Head AIS Score in the short-term prediction of death after TBI.
Authors: Vijay Krishnamoorthy; Monica S Vavilala; Nophanan Chaikittisilpa; Frederick P Rivara; Nancy R Temkin; Abhijit V Lele; Edward F Gibbons; Ali Rowhani-Rahbar Journal: Crit Care Med Date: 2018-06 Impact factor: 7.598
Authors: Anthony O Asemota; Benjamin P George; Carolyn J Cumpsty-Fowler; Adil H Haider; Eric B Schneider Journal: J Neurotrauma Date: 2013-11-06 Impact factor: 5.269
Authors: Natasha L Heather; José G B Derraik; John Beca; Paul L Hofman; Rangi Dansey; James Hamill; Wayne S Cutfield Journal: PLoS One Date: 2013-12-02 Impact factor: 3.240
Authors: Patrick T Delaplain; Areg Grigorian; Michael Lekawa; Michael Mallicote; Victor Joe; Sebastian D Schubl; Catherine M Kuza; Matthew Dolich; Jeffry Nahmias Journal: Pediatr Surg Int Date: 2020-01-14 Impact factor: 1.827
Authors: S M Bossers; K M Pol; E P A Oude Ophuis; B Jacobs; M C Visser; S A Loer; C Boer; J van der Naalt; P Schober Journal: Eur J Trauma Emerg Surg Date: 2017-10-14 Impact factor: 3.693