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Simplified Scoring System of Donohue et al for Predicting 1 Year Mortality in an Elderly Patient with Significant Head Injury

Purpose: To evaluate an elderly patient with a significant head injury using the simplified scoring system of Donohue et al.

Description

Donohue et al developed a simplified scoring system for predicting 1 year mortality in an elderly patient following significant head injury. The authors are from the Maine Medical Center in Portland and the Harvard Injury Control Research Center in Boston.


Patient selection:

(1) age >= 65 years

(2) significant head injury, with AIS >= 3

(3) survived at least 1 day after the head injury

 

Parameters:

(1) gender

(2) age in years

(3) Charlson comorbidity score

(4) maximum AIS (Abbreviated Injury Score)

(5) loss of consciousness (LOC)

 

Parameter

Findings

Points

gender

female

2

 

male

2.5

age in years

65 to 74

0

 

75 to 84

1.5

 

>= 85

3.5

Charlson comorbidity

0

0

 

1

0.5

 

2

2

 

>= 3

3.5

maximum AIS

3

0

 

4

1

 

5

7.5

loss of consciousness (LOC)

none or brief

0

 

prolonged

1

 

total score =

= SUM(points for all 5 parameters)

 

estimated mortality rate by 1 year =

= MIN((total score) * 7%, 95%)


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Specialty

Objective

ICD-10