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Decision Tree of Andrews et al for Predicting Outcome After Traumatic Brain Injury Using Demographic and Clinical Data

Purpose: To evaluate a patient with a traumatic head injury using one of the decision trees of Andrews et al.

Description

Andrews et al developed a number of decision trees to determine the outcome following traumatic brain injury. These can help identify patients who may benefit from more aggressive management. The authors are from the University of Edinburgh and the University of Aberdeen in Scotland.


Patient selection: age >= 16 years with traumatic brain injury

 

Outcome

Glasgow Outcome Score (GOS)

good

4 or 5

bad

1, 2 or 3

 

Parameters:

(1) number of pupils reactive to light

(2) road accident

(3) diagnosis (apparently only 1 scored)

(4) gender of the patient

(5) referral source (RS - ER or outside hospital)

(6) age of the patient in years

(7) grade of head injury (GHI - minor, moderate or severe)

(8) Glasgow coma score (GCS)

(9) isolated head injury (IHI)

 

Diagnosis

Score

evacuated extradural hematoma

1

acute subdural hematoma

2

intradural hematoma

3

nonevacuated hematoma

4

diffuse injury

5

other

6

 

 

Pupil

Road

Dx

Sex

RS

Age

GHI

GCS

IHI

End Node

0

Y

 

 

 

 

 

 

 

A

0

N

4-6

 

 

 

 

 

 

B

0

N

1-3

 

 

 

 

 

 

C

1-2

 

 

F

ER

 

 

 

 

D

1-2

 

 

F

OH

 

 

 

 

E

1-2

Y

 

M

 

>53

 

 

 

F

1-2

N

 

M

 

>53

 

 

 

G

1-2

 

 

M

 

<=53

3

6

Y

H

1-2

 

 

M

 

<=53

3

7-15

Y

I

1-2

 

 

M

 

<=53

3

6-15

N

J

1-2

 

1

M

 

<=53

3

3-5

N

K

1-2

 

2-6

M

 

30-53

3

3-5

N

L

1-2

 

2-6

M

 

< 30

3

3-5

N

M

1-2

 

 

M

 

<=53

3

3-5

Y

N

1-2

 

 

M

 

<=53

1-2

 

 

O

 

Nodes with good outcome: B, D, F, H, J, K, M, N, O

 

Nodes with bad outcome: A, C, E, G, I, L


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Specialty

Objective

ICD-10