Prediction Tree of Rovlias and Kotsou for Outcome of an Adult with Severe Head Injury

Description

Rovlias and Kotsou evaluated adults with severe head injuries, often related to motor vehicle accidents. They developed a prediction tree for unfavorable outcome. The authors are from Asclepeion General Hospital in Athens, Greece.

Patient selection: adult severe head injury (Glasgow coma score <= 8)

Exclusion: significant extracranial injury (abdominal, thoracic, pelvic, fracture, spinal cord)

Outcome: unfavorable at 6 months (severe disability, persistent vegetative state, death)

Glasgow Coma Score <=5

Pupillary Response	Age in Years	Glucose on Admission	Unfavorable Outcome
absent in 1 or both eyes	NA	NA	97%
present in both	> 48 years	NA	92%
present in both	<= 48 years	> 179 mg/dL	71%
present in both	<= 48 years	<= 179 mg/dL	10%

Glasgow Coma Score 6 to 8

Glucose on Second Day	SAH	Intracranial Diagnosis	WBC Count on Admission	Unfavorable Outcome
<= 169 mg/dL	absent	NA	NA	1.5%
<= 169 mg/dL	present	NA	NA	29%
> 169 mg/dL	NA	subdural or intracranial hematoma	NA	89%
> 169 mg/dL	NA	epidural hematoma or diffuse brain injury	<= 15,700 per µL	16%
> 169 mg/dL	NA	epidural hematoma or diffuse brain injury	> 15,700 per µL	43%

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Prediction Tree of Rovlias and Kotsou for Outcome of an Adult with Severe Head Injury

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