van der Naalt et al reported a model for predicting outcome for a patient with mild traumatic brain injury (TBI). This can help to identify a patient who may benefit from more aggressive management. The authors are from the University of Groningen and multiple hospitals in The Netherlands.
Patient selection: mild traumatic brain injury (TBI), Glasgow coma scale 13 to 15
Outcome: complete recovery at 6 months
Parameters:
(1) education on Dutch 7 point scale
(2) mental health problems
(3) alcohol consumption on day of injury
(4) Glasgow coma scale (GCS) on admission
(5) post-traumatic amnesic (PTA)
(6) neck pain
(7) depression on the HADS (from 0 to 22)
(8) anxiety on the HADS (from 0 to 18)
(9) post-traumatic complaints (Head Injury Symptoms Score or HISC, from 0 to 42)
(10) Utrecht Coping List (UCL) passive subscale from 1 (low) to 5 (very high)
(11) Utrecht Coping List (UCL) avoidant subscale from 1 (low) to 5 (very high)
points for depression =
= (-4.54545 * (HADS depression)) + 100
points for anxiety =
= (1.935 * (HADS anxiety))
points for post-traumatic complaints from 0 to 18 =
= (-1.8 * (complaints)) + 32.4
Parameters |
Findings |
Points |
education |
3 (finished 7-8 years) |
0 |
|
4 (finished 9 years) |
8.1 |
|
5 (finished 10-11 years) |
16.2 |
|
6 (finished 12-16 years) |
24.3 |
|
7 (university > 16 years) |
32.4 |
mental health problems |
no |
20.9 |
|
yes |
0 |
alcohol consumption |
no |
0 |
|
yes |
17.1 |
GCS |
13 |
0 |
|
14 |
13 |
|
15 |
26 |
PTA |
< 1 hour |
0 |
|
>= 1 hour |
15 |
neck pain |
no |
19.8 |
|
yes |
0 |
UCL passive |
5 |
0 |
|
4 |
4.7 |
|
3 |
9.4 |
|
2 |
14.1 |
|
1 |
18.8 |
UCL avoidant |
5 |
22.4 |
|
4 |
16.8 |
|
3 |
11.2 |
|
2 |
5.6 |
|
1 |
0 |
total score =
= SUM(points for all 11 parameters)
Interpretation:
• minimum score: 0
• maximum score: 343.8
Score |
Linear Predictor |
< 104.7 |
< -5 |
104.7 to 307.4 |
(0.044353 * (score)) - 9.6491 |
> 307.4 |
> 4 |
probability of complete recovery at 6 months =
= 1 / (1 + EXP((-1) * (linear predictor))
Specialty: Sports Medicine & Rehabilitation, Neurology