Signorini et al developed a model for predicting survival after traumatic head injury. This can help identify patients who may benefit from more aggressive management. The authors are from the University of Edinburgh in Scotland.
Parameters:
(1) age
(2) injury severity score (ISS)
(3) Glasgow coma score (GCS)
(4) number of reactive pupils
(5) presence of hematoma on CT scan
|
Age |
Points |
|---|---|
|
> 90 |
0 |
|
50 - 90 |
(-2.5 * (age in years)) + 225 |
|
14 - 50 |
100 |
|
ISS |
Points |
|---|---|
|
> 75 |
6 |
|
0 - 75 |
(-1.25 * (ISS)) + 100.1398 |
|
GCS |
Points |
|---|---|
|
3 |
0 |
|
4 |
5.5 |
|
5 |
11 |
|
6 |
17 |
|
7 |
22.5 |
|
8 |
27.5 |
|
9 |
33 |
|
10 |
38 |
|
11 |
44 |
|
12 |
50 |
|
13 |
56 |
|
14 |
61 |
|
15 |
67 |
|
Reactive Pupils |
Points |
|---|---|
|
0 |
0 |
|
1 |
25 |
|
2 |
37 |
|
Hematoma on CT |
Points |
|---|---|
|
absent |
25 |
|
present |
0 |
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 329
• The higher the score the greater the chances of survival.
|
Point Range |
Probability of Survival |
|---|---|
|
0 - 42 |
<= 0.001 |
|
42 - 75 |
0.001 to 0.005 |
|
75 - 89 |
0.005 - 0.01 |
probability of survival =
= (A * ((points)^2)) + (B * (points)) + C
|
Point Range |
A |
B |
C |
|---|---|---|---|
|
89 - 140 |
0.0000346 |
-0.006159 |
0.284083 |
|
140 - 182 |
0.000092 |
-0.020097 |
1.1106 |
|
182 - 227 |
-0.00009 |
0.0457115 |
-4.837308 |
|
227 - 277 |
-0.000039 |
0.0214412 |
-1.959032 |
|
Point Range |
Probability of Survival |
|---|---|
|
277 - 292 |
0.990 - 0.995 |
|
292 - 324 |
0.995 - 0.999 |
|
> 324 |
> 0.999 |
Alternatively, solving this is a logistic regression:
X =
= (0.048988 * (total points)) - 8.963537
probability =
= 1 / (1 + EXP((-1) * X))
Purpose: To estimate the risk of survival for a patient following traumatic brain injury using the model of Signorini et al.
Specialty: Surgery, orthopedic, Emergency Medicine, Critical Care, Surgery, general, Otolaryngology
Objective: severity, prognosis, stage
ICD-10: S06,
