Description

van der Naalt et al reported a model for predicting outcome for a patient with mild traumatic brain injury (TBI). This can help to identify a patient who may benefit from more aggressive management. The authors are from the University of Groningen and multiple hospitals in The Netherlands.


Patient selection: mild traumatic brain injury (TBI), Glasgow coma scale 13 to 15

 

Outcome: complete recovery at 6 months

Parameters:

(1) education on Dutch 7 point scale

(2) mental health problems

(3) alcohol consumption on day of injury

(4) Glasgow coma scale (GCS) on admission

(5) post-traumatic amnesic (PTA)

(6) neck pain

(7) depression on the HADS (from 0 to 22)

(8) anxiety on the HADS (from 0 to 18)

(9) post-traumatic complaints (Head Injury Symptoms Score or HISC, from 0 to 42)

(10) Utrecht Coping List (UCL) passive subscale from 1 (low) to 5 (very high)

(11) Utrecht Coping List (UCL) avoidant subscale from 1 (low) to 5 (very high)

 

points for depression =

= (-4.54545 * (HADS depression)) + 100

 

points for anxiety =

= (1.935 * (HADS anxiety))

 

points for post-traumatic complaints from 0 to 18 =

= (-1.8 * (complaints)) + 32.4

 

Parameters

Findings

Points

education

3 (finished 7-8 years)

0

 

4 (finished 9 years)

8.1

 

5 (finished 10-11 years)

16.2

 

6 (finished 12-16 years)

24.3

 

7 (university > 16 years)

32.4

mental health problems

no

20.9

 

yes

0

alcohol consumption

no

0

 

yes

17.1

GCS

13

0

 

14

13

 

15

26

PTA

< 1 hour

0

 

>= 1 hour

15

neck pain

no

19.8

 

yes

0

UCL passive

5

0

 

4

4.7

 

3

9.4

 

2

14.1

 

1

18.8

UCL avoidant

5

22.4

 

4

16.8

 

3

11.2

 

2

5.6

 

1

0

 

total score =

= SUM(points for all 11 parameters)

 

Interpretation:

minimum score: 0

maximum score: 343.8

 

Score

Linear Predictor

< 104.7

< -5

104.7 to 307.4

(0.044353 * (score)) - 9.6491

> 307.4

> 4

 

probability of complete recovery at 6 months =

= 1 / (1 + EXP((-1) * (linear predictor))


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