Citation

Timmons SD, Bee T, Webb S, Diaz-Arrastia RR, Hesdorffer D. J. Trauma 2011; 71(5): 1172-1178.

Affiliation

Department of Neurosurgery (S.D.T.), Semmes-Murphey Clinic and University of Tennessee Health Science Center, Memphis, Tennessee; Department of Surgery (T.B.), University of Tennessee Health Science Center, Memphis, Tennessee; Department of Neurosurgery (S.W.), University of South Carolina, Columbia, South Carolina; Department of Neurology (R.R.D.-A.), University of Texas Southwestern Medical Center, Dallas, Texas; and Columbia University Gertrude H. Sergievsky Center and Department of Epidemiology (D.H.), New York, New York.

Copyright

(Copyright © 2011, Lippincott Williams and Wilkins)

DOI

10.1097/TA.0b013e31822b0f4b

PMID

22071922

Abstract

BACKGROUND:: Prediction of outcome after traumatic brain injury (TBI) remains elusive. We tested the use of a single hospital Glasgow Coma Scale (GCS) Score, GCS Motor Score, and the Head component of the Abbreviated Injury Scale (AIS) Score to predict 2-week cumulative mortality in a large cohort of TBI patients admitted to the eight U.S. Level I trauma centers in the TBI Clinical Trials Network. METHODS:: Data on 2,808 TBI patients were entered into a centralized database. These TBI patients were categorized as severe (GCS score, 3-8), moderate (9-12), or complicated mild (13-15 with positive computed tomography findings). Intubation and chemical paralysis were recorded. The cumulative incidence of mortality in the first 2 weeks after head injury was calculated using Kaplan-Meier survival analysis. Cox proportional hazards regression was used to estimate the magnitude of the risk for 2-week mortality. RESULTS:: Two-week cumulative mortality was independently predicted by GCS, GCS Motor Score, and Head AIS. GCS Severity Category and GCS Motor Score were stronger predictors of 2-week mortality than Head AIS. There was also an independent effect of age (<60 vs. ≥60) on mortality after controlling for both GCS and Head AIS Scores. CONCLUSIONS:: Anatomic and physiologic scales are useful in the prediction of mortality after TBI. We did not demonstrate any added benefit to combining the total GCS or GCS Motor Scores with the Head AIS Score in the short-term prediction of death after TBI.

Language: en