Outcome prediction model for severe diffuse brain injuries: development and evaluation.

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dc.contributor.authorPillai, S Ven_US
dc.contributor.authorKolluri, V Ren_US
dc.contributor.authorPraharaj, S Sen_US
dc.date.accessioned2003-09-04en_US
dc.date.accessioned2009-06-03T11:37:52Z
dc.date.available2003-09-04en_US
dc.date.available2009-06-03T11:37:52Z
dc.date.issued2003-09-04en_US
dc.description.abstractBACKGROUND: Intensive care resources for the management of severe diffuse brain injury patients (SDBI) are limited. Their optimal use is possible only if we can predict at admission which patients are unlikely to improve. AIMS: To develop a simple and effective model to predict poor outcome in patients with SDBI in order to help guide initial therapy. MATERIAL AND METHODS: The prognostic factors and outcomes of 289 patients with severe diffuse brain injury (GCS 3-8) were analyzed retrospectively. The prognostic factors analyzed were age, mode of injury, GCS at admission, pupillary reaction, horizontal oculocephalic reflex, and CT scan findings. Outcome at 1 month was classified as unfavorable--death or persistent vegetative state, or favorable--improvement with or without some disability. A stepwise linear logistic regression analysis was used to identify the most important predictors of poor outcome. A prediction model (NIMHANS model-NM) was developed using these factors. NM and several currently available outcome prediction models were prospectively applied in a separate group of 26 patients with severe diffuse brain injury managed with a different protocol. RESULTS: The most important predictors of poor outcome were found to be the horizontal oculocephalic reflex, motor score of GCS, and midline shift on CT scan. NM was found to be more sensitive (75%) and specific (67%) than most other models in predicting unfavorable outcome. NM had high false pessimistic results (33%). CONCLUSION: Prediction models cannot be used to guide initial therapy.en_US
dc.description.affiliationDepartment of Neurosurgery, NIMHANS, Bangalore - 560029, India. drshibupillai@hotmail.comen_US
dc.identifier.citationPillai SV, Kolluri VR, Praharaj SS. Outcome prediction model for severe diffuse brain injuries: development and evaluation. Neurology India. 2003 Sep; 51(3): 345-9en_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/121016
dc.language.isoengen_US
dc.source.urihttps://neurologyindia.comen_US
dc.subject.meshAdulten_US
dc.subject.meshBrain Injuries --mortalityen_US
dc.subject.meshFemaleen_US
dc.subject.meshHumansen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshPredictive Value of Testsen_US
dc.subject.meshPrognosisen_US
dc.subject.meshRetrospective Studiesen_US
dc.subject.meshSeverity of Illness Indexen_US
dc.subject.meshTomography, X-Ray Computeden_US
dc.titleOutcome prediction model for severe diffuse brain injuries: development and evaluation.en_US
dc.typeJournal Articleen_US
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