• Simpiwe Sobuwa, Henry Benjamin Hartzenberg, Heike Geduld, and Corrie Uys.
• Department of Emergency Medical Sciences, Faculty of Health and Wellness Sciences, Cape Peninsula University of Technology, Cape Town, South Africa. simpiwesobuwa@gmail.com.
• S. Afr. Med. J. 2014 Jul 1;104(7):492-4.

BackgroundSeveral studies have made it possible to predict outcome in severe traumatic brain injury (TBI) making it beneficial as an aid for clinical decision-making in the emergency setting. However, reliable predictive models are lacking for resource-limited prehospital settings such as those in developing countries like South Africa.ObjectiveTo develop a simple predictive model for severe TBI using clinical variables in a South African prehospital setting.MethodsAll consecutive patients admitted at two level-one centres in Cape Town, South Africa, for severe TBI were included. A binary logistic regression model was used, which included three predictor variables: oxygen saturation (SpO₂), Glasgow Coma Scale (GCS) and pupil reactivity. The Glasgow Outcome Scale was used to assess outcome on hospital discharge.ResultsA total of 74.4% of the outcomes were correctly predicted by the logistic regression model. The model demonstrated SpO₂ (p=0.019), GCS (p=0.001) and pupil reactivity (p=0.002) as independently significant predictors of outcome in severe TBI. Odds ratios of a good outcome were 3.148 (SpO₂ ≥ 90%), 5.108 (GCS 6 - 8) and 4.405 (pupils bilaterally reactive).ConclusionThis model is potentially useful for effective predictions of outcome in severe TBI.

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