Pillai et al reported a model for predicting the outcome of a patient with severe diffuse brain injury. The authors are from the National Institute of Mental Health and Neurosciences (NIMHANS).
Patient selection: severe diffuse brain injury
Parameters:
(1) horizontal oculocephalic reflex (doll's eyes reflex)
(2) motor score of the GCS, from 1 to 5
(3) midline shift in mm
Parameter
Finding
Points
oculocephalic reflex
absent
3
present
6
GCS motor score
0.5 * (motor score)
midline shift
0 mm
-1
>= 5 mm
-3
total score =
= SUM(points for all of the parameters) - 6.6
Interpretation:
• minimum score: -6.5
• maximum score: 1.4
• A score < 0 is likely to be unfavorable.
Performance:
• The score had a sensitivity of 75% and specificity of 67% for unfavorable outcome.
• The prediction was falsely pessimistic in 33%.
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Specialty: Surgery, orthopedic
