Title
Predicting outcome after traumatic brain injury: Practical prognostic models based on large cohort of international patients
Date Issued
23 February 2008
Access level
open access
Resource Type
journal article
Author(s)
Perel P.A.
Olldashi F.
Muzha I.
Filipi N.
Lede R.
Copertari P.
Traverso C.
Copertari A.
Vergara E.A.
Montenegro C.
De Huidobro R.R.
Saladino P.
Surt K.
Cialzeta J.
Lazzeri S.
Piñero G.
Ciccioli F.
Videtta W.
Barboza M.F.
Svampa S.
Sciuto V.
Domeniconi G.
Bustamante M.
Waschbusch M.
Gullo M.P.
Drago D.A.
Linares J.C.A.
Camputaro L.
Tróccoli G.
Galimberti H.
Tallott M.
Eybner C.
Buchinger W.
Fitzal S.
Mazairac G.
Oleffe V.
Grollinger T.
Delvaux P.
Carlier L.
Braet V.
Jacques J.M.
De Knoop D.
Nasi L.
Choi H.K.
Schmitt M.
Gentil A.
Nacul F.
Barrios P.B.
Xinkang C.
Hua L.S.
Tian H.H.
Xiaodong C.
Gualteros W.
Otero A.A.
Arango M.
Ciro J.
Jaramillo H.
Gonzalez I.
Gomez C.
Arias A.
Fonseca M.
Mora C.
Cabrera E.G.L.
Betancurth J.L.
Muñoz P.
Quiñónez J.A.
Castillo M.E.G.
Lopez O.
Yepes R.P.
Cuellar D.L.
Paez G.
Chaves H.D.
Ordoñez P.E.
Plata R.
Pineda M.
Pulido L.E.
Jaramillo J.S.V.
Rebolledo C.
Palma O.
Soler C.
Pastrana I.
Falero R.
Perera M.D.
García A.A.
Oliva R.
Delgado H.L.
Carnero A.M.
López B.L.
Gallardo A.L.
Morales A.O.
Lezcano H.
Ferrer M.I.
Bess I.Z.
Canino G.R.
Ruiz E.M.P.
Cruz O.G.
Svoboda P.
Kantorová I.
Ochmann J.
Scheer P.
Hospital San Bernardo
Publisher(s)
BMJ Publishing Group
Abstract
Objective: To develop and validate practical prognostic models for death at 14 days and for death or severe disability six months after traumatic brain injury. Design: Multivariable logistic regression to select variables that were independently associated with two patient outcomes. Two models designed: "basic" model (demographic and clinical variables only) and "CT" model (basic model plus results of computed tomography). The models were subsequently developed for high and low-middle income countries separately. Setting: Medical Research Council (MRC) CRASH Trial. Subjects: 10 008 patients with traumatic brain injury. Models externally validated in a cohort of 8509. Results: The basic model included four predictors: age, Glasgow coma scale, pupil reactivity, and the presence of major extracranial injury. The CT model also included the presence of petechial haemorrhages, obliteration of the third ventricle or basal cisterns, subarachnoid bleeding, midline shift, and non-evacuated haematoma. In the derivation sample the models showed excellent discrimination (C statistic above 0.80). The models showed good calibration graphically. The Hosmer-Lemeshow test also indicated good calibration, except for the CT model in low-middle income countries. External validation for unfavourable outcome at six months in high income countries showed that basic and CT models had good discrimination (C statistic 0.77 for both models) but poorer calibration. Conclusion: Simple prognostic models can be used to obtain valid predictions of relevant outcomes in patients with traumatic brain injury.
Start page
425
End page
429
Volume
336
Issue
7641
Language
English
OCDE Knowledge area
Neurociencias
Neurología clínica
Scopus EID
2-s2.0-39749151654
PubMed ID
Source
BMJ
ISSN of the container
09598146
Sources of information:
Directorio de Producción Científica
Scopus