Tasaki et al developed a prognostic model for predicting outcome following severe traumatic brain injury. This model can help to identify patients who may have a worse outcome and need long-term care. The authors are from Osaka University in Japan.
Patient selection: traumatic brain injury with Glasgow coma score < 9 on admission or deterioration to < 9 within 12 hours after injury
Exclusions: brain dead on admission, hemorrhagic shock, alcohol-induced coma
Outcomes: favorable (good recovery or moderate disability) or unfavorable (persistent vegetative state or death)
Parameters:
(1) age in years
(2) intracranial pressure (ICP) in mm Hg
(3) midline shift of the brain on imaging studies in mm
(4) subarachnoid hemorrhage
(5) pupillary light reflex (LR)
Parameter
Finding
Points
subarachnoid hemorrhage
absent or not extensive
0
extensive
1
pupillary light reflex
present on one or both sides
1
absent bilaterally
0
X =
= (0.11 * (age in years)) + (0.16 * (midline shift in mm)) + (3.44 * (points for subarachnoid hemorrhage)) - (4.09 * (points for papillary light reflex)) + (0.12 * (intracranial pressure in mm Hg)) - 4.51
probability of an unfavorable outcome =
= 1 / (1 + EXP((-1) * X))
probability of a favorable outcome =
= 1 - (probability of an unfavorable outcome)
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