Ramesh et al developed the Madras Head Injury Prognostic Scale (MHIPS). This can help determine the outcome for a trauma patient with a head injury. The authors are from Madras Medical College and the Government General Hospital in Chennai, India.
Parameters:
(1) age of the patient in years
(2) best motor response from the Glasgow coma scale
(3) pupillary light response
(4) oculocephalic response
(5) CT scan findings
(6) systemic injuries
Parameter
Findings
Points
age of the patient
< 15 years
3
15 to 45 years
2
> 45 years
1
best motor response
5 or 6
3
3 or 4
2
1 or 2
1
pupillary light response
normal
3
impaired
2
absent
1
oculocephalic response
normal
3
impaired
2
absent
1
CT scan findings
normal
3
partially effaced basal cisterns OR midline shift < 5 mm OR lesion density < 3 cm
2
absent basal cisterns OR midline shift >= 5 mm OR lesion density >= 3 cm
1
systemic injuries
no other injuries
3
1 or 2 long bone fractures
2
3 or more long bone fractures OR visceral injuries (thoracic, abdominal, pelvic)
1
where:
• The measurements for the CT findings are "<" or ">" in the original table.
• Pelvic visceral injuries was added to systemic injuries.
total score =
= SUM(points for all 6 parameters)
Interpretation:
• minimum score: 6
• maximum score: 18
• The higher the score the better the prognosis.
MHIPS
Outcome
15 to 18
good
13 or 14
severely disabled or vegetative
6 to 12
death
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