• Yunpeng Kou, Shaochun Guo, Zhicheng Fan, Chenchen Zhou, Wenqian Zhou, Yuan Wang, Peigang Ji, Jinghui Liu, Yulong Zhai, Min Chao, Yang Jiao, Wenjian Zhao, Chao Fan, Na Wang, Xueyong Liu, and Liang Wang.
• The Second Clinical Medical College, Shaanxi University of Chinese Medicine, Xianyang, China; Department of Neurosurgery, Tangdu Hospital, The Fourth Military Medical University, Xi'an, China.
• World Neurosurg. 2024 Oct 1; 190: e891e919e891-e919.

ObjectiveTo explore mortality risk factors and to construct an online nomogram for predicting in-hospital mortality in traumatic brain injury (TBI) patients receiving invasive mechanical ventilation (IMV) in intensive care unit (ICU).MethodsWe retrospectively analyzed TBI patients on IMV in ICU from Medical Information Mart for Intensive Care IV database and 2 hospitals. Least absolute shrinkage and selection operation regression and multiple logistic regression were used to detect predictors of in-hospital mortality and to construct an online nomogram. The predictive performance of nomogram was evaluated using area under the receiver operating characteristic curves (AUC), calibration curves, decision curve analysis, and clinical impact curves.ResultsFive hundred ten from Medical Information Mart for Intensive Care IV database were enrolled for nomogram construction (80%, n = 408) and internal validation (20%, n = 102). One hundred eighty-five from 2 hospitals were enrolled for external validation. Least absolute shrinkage and selection operation-logistic regression revealed predictors of in-hospital mortality among TBI patients on IMV in ICU included Glasgow Coma Scale (GCS) after ICU admission, Acute Physiology Score III (APS III) after ICU admission, neutrophil and lymphocyte ratio after IMV, blood urea nitrogen after IMV, arterial serum lactate after IMV, and in-hospital tracheotomy. The AUC, calibration curves, decision curve analysis, and clinical impact curves indicated the nomogram had good discrimination, calibration, clinical benefit, and applicability. The multimodel comparisons revealed the nomogram had higher AUC than GCS, APS III, and Simplified Acute Physiology Score II.ConclusionsWe constructed and validated an online nomogram based on routinely recorded factors at admission to ICU and at the beginning of IMV to target prediction of in-hospital mortality among TBI patients on IMV in ICU.Copyright © 2024 Elsevier Inc. All rights reserved.

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