|
Title
|
|
|
|
Outcome prediction after mild and complicated mild traumatic brain injury : external validation of existing models and identification of new predictors using the TRACK-TBI pilot study
| |
|
Author
|
|
|
|
| |
|
Institution/Organisation
|
|
|
|
TRACK-TBI Investigators
| |
|
Abstract
|
|
|
|
| Although the majority of patients with mild traumatic brain injury (mTBI) recover completely, some still suffer from disabling ailments at 3 or 6 months. We validated existing prognostic models for mTBI and explored predictors of poor outcome after mTBI. We selected patients with mTBI from TRACK-TBI Pilot, an unselected observational cohort of TBI patients from three centers in the United States. We validated two prognostic models for the Glasgow Outcome Scale Extended (GOS-E) at 6 months after injury. One model was based on the CRASH study data and another from Nijmegen, The Netherlands. Possible predictors of 3- and 6-month GOS-E were analyzed with univariate and multi-variable proportional odds regression models. Of the 386 of 485 patients included in the study (median age, 44 years; interquartile range, 27-58), 75% (n=290) presented with a Glasgow Coma Score (GCS) of 15. In this mTBI population, both previously developed models had a poor performance (area under the receiver operating characteristic curve, 0.49-0.56). In multivariable analyses, the strongest predictors of lower 3- and 6-month GOS-E were older age, pre-existing psychiatric conditions, and lower education. Injury caused by assault, extracranial injuries, and lower GCS were also predictive of lower GOS-E. Existing models for mTBI performed unsatisfactorily. Our study shows that, for mTBI, different predictors are relevant as for moderate and severe TBI. These include age, pre-existing psychiatric conditions, and lower education. Development of a valid prediction model for mTBI patients requires further research efforts. |
| |
|
Language
|
|
|
|
English
| |
|
Source (journal)
|
|
|
|
Journal of neurotrauma. - New York
| |
|
Publication
|
|
|
|
New York
:
2015
| |
|
ISSN
|
|
|
|
1557-9042
[online]
0897-7151
[print]
| |
|
DOI
|
|
|
|
10.1089/NEU.2014.3384
| |
|
Volume/pages
|
|
|
|
32
:2
(2015)
, p. 83-94
| |
|
ISI
|
|
|
|
000347690700002
| |
|
Full text (Publisher's DOI)
|
|
|
|
| |
|
Full text (open access)
|
|
|
|
| |
|