Andrews et al developed a number of decision trees to determine the outcome following traumatic brain injury. These can help identify patients who may benefit from more aggressive management. The authors are from the University of Edinburgh and the University of Aberdeen in Scotland.
Patient selection: age >= 16 years with traumatic brain injury
|
Outcome |
Glasgow Outcome Score (GOS) |
|---|---|
|
good |
4 or 5 |
|
bad |
1, 2 or 3 |
Parameters:
(1) number of pupils reactive to light
(2) road accident
(3) diagnosis (apparently only 1 scored)
(4) gender of the patient
(5) referral source (RS - ER or outside hospital)
(6) age of the patient in years
(7) grade of head injury (GHI - minor, moderate or severe)
(8) Glasgow coma score (GCS)
(9) isolated head injury (IHI)
|
Diagnosis |
Score |
|---|---|
|
evacuated extradural hematoma |
1 |
|
acute subdural hematoma |
2 |
|
intradural hematoma |
3 |
|
nonevacuated hematoma |
4 |
|
diffuse injury |
5 |
|
other |
6 |
|
Pupil |
Road |
Dx |
Sex |
RS |
Age |
GHI |
GCS |
IHI |
End Node |
|---|---|---|---|---|---|---|---|---|---|
|
0 |
Y |
|
|
|
|
|
|
|
A |
|
0 |
N |
4-6 |
|
|
|
|
|
|
B |
|
0 |
N |
1-3 |
|
|
|
|
|
|
C |
|
1-2 |
|
|
F |
ER |
|
|
|
|
D |
|
1-2 |
|
|
F |
OH |
|
|
|
|
E |
|
1-2 |
Y |
|
M |
|
>53 |
|
|
|
F |
|
1-2 |
N |
|
M |
|
>53 |
|
|
|
G |
|
1-2 |
|
|
M |
|
<=53 |
3 |
6 |
Y |
H |
|
1-2 |
|
|
M |
|
<=53 |
3 |
7-15 |
Y |
I |
|
1-2 |
|
|
M |
|
<=53 |
3 |
6-15 |
N |
J |
|
1-2 |
|
1 |
M |
|
<=53 |
3 |
3-5 |
N |
K |
|
1-2 |
|
2-6 |
M |
|
30-53 |
3 |
3-5 |
N |
L |
|
1-2 |
|
2-6 |
M |
|
< 30 |
3 |
3-5 |
N |
M |
|
1-2 |
|
|
M |
|
<=53 |
3 |
3-5 |
Y |
N |
|
1-2 |
|
|
M |
|
<=53 |
1-2 |
|
|
O |
Nodes with good outcome: B, D, F, H, J, K, M, N, O
Nodes with bad outcome: A, C, E, G, I, L
Purpose: To evaluate a patient with a traumatic head injury using one of the decision trees of Andrews et al.
Specialty: Surgery, orthopedic, Emergency Medicine, Critical Care, Surgery, general, Otolaryngology
Objective: severity, prognosis, stage
ICD-10: S06,
