Predicting progressive hemorrhagic injury after traumatic brain injury: derivation and validation of a risk score based on admission characteristics.

Journal of Neurotrauma
Fang YuanHeng-Li Tian

Abstract

Previous studies have demonstrated that patients with traumatic brain injury (TBI) who also have progressive hemorrhagic injury (PHI), have a higher risk of clinical deterioration and worse outcomes than do TBI patients without PHI. Therefore, the early prediction of PHI occurrence is useful to evaluate the status of patients with TBI and to improve outcomes. The objective of this study was to develop and validate a prognostic model that uses information available at admission to determine the likelihood of PHI after TBI. Retrospectively collected data were used to develop a PHI prognostic model with a logistic regression analysis. The prediction model was validated in 114 patients from a separate hospital. Eight independent prognostic factors were identified: age ≥ 57 years (5 points), intra-axial bleeding/brain contusion (4 points), midline shift ≥ 5 mm (6 points), platelet (PLT) count<100×10⁹/L (10 points), PLT count ≥ 100 but <150×10⁹/L (4 points), prothrombin time>14 sec (7 points), D-dimer ≥ 5 mg/L (12 points), and glucose ≥ 10 mmol/L (10 points). Each patient was assigned a number of points proportional to the regression coefficient. We calculated risk scores for each patient and defined three risk groups: low risk (0-13...Continue Reading

References

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Citations

Sep 11, 2013·PloS One·Dawei DaiHengli Tian
Aug 28, 2014·The Journal of Trauma and Acute Care Surgery·Bellal JosephPeter Rhee
Jan 16, 2020·International Journal of Molecular Sciences·Ruchira M JhaJ Marc Simard
Nov 19, 2020·Journal of Neurotrauma·Ruchira M JhaPatrick M Kochanek

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Brain Injury & Trauma

brain injury after impact to the head is due to both immediate mechanical effects and delayed responses of neural tissues.