• World Neurosurg · Feb 2021

    Outcome Prediction of TBI: Are There Parameters That Affect the IMPACT and CRASH Models?

    • Kanchan Bilgi, Kadarapura Nanjundaiah Gopalakrishna, Dhritiman Chakrabarti, and RaoG S UmamaheswaraGSUDepartment of Neuroanaesthesia and Neurocritical Care, National Institute of Mental Health and Neurosciences, Bengaluru, India..
    • Department of Neuroanaesthesiology, Vikram Hospital, Bengaluru, India. Electronic address: kanchanbilgi@gmail.com.
    • World Neurosurg. 2021 Feb 1; 146: e590-e596.

    BackgroundAbnormal hematologic parameters associated with unfavorable neurological outcomes in traumatic brain injury (TBI) have been studied in isolation. We aimed to study whether there are any additional parameters that improve standard prognostic models in TBI.MethodsThis prospective observational study conducted in a tertiary neurological care center included adult patients with moderate and severe isolated head injury. Laboratory and clinical parameters were noted at admission, and the Glasgow Outcome Score-Extended of patients was assessed after 6 months. Multiple logistic regression was conducted using fixed coefficients of IMPACT (International Mission for Prognosis and Analysis of Clinical Trials) and CRASH (Corticosteroid Randomisation After Significant Head Injury) prognostic models. The new composite models were compared with the original models.ResultsThe study comprised 96 patients. Parameters with relatively good predictability for mortality were elevated international normalized ratio (area under the curve [AUC] 0.69, odds ratio 13.2), total leukocyte count (AUC 0.68, odds ratio 1.15), and transfusion of blood products (AUC 0.72, odds ratio 6.43). Addition of these led to a statistically small improvement in predictions of IMPACT and CRASH. Neutrophil-to-lymphocyte ratio was not a good predictor of mortality or morbidity (AUC 0.58 and 0.47, respectively).ConclusionsInternational normalized ratio, total leukocyte count, and blood transfusion were found to be predictors of mortality and unfavorable neurological outcome in TBI at 6 months. Their addition to the IMPACT and CRASH prognostic models resulted in a modest improvement in the prediction of outcome in TBI.Copyright © 2020 Elsevier Inc. All rights reserved.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…