Steyerberg et al developed prognostic scores for patients with traumatic brain injury.
The authors are from Erasmus MC Rotterdam, London School of Hygiene and Tropical Mediciine, University of Edinburgh, and Virginia Commonwealth University.
Patient selection: adult with traumatic brain injury (TBI)
Outcome: Glasgow outcome score (GOS)
Parameters on admission:
(1) age in years
(2) motor score
(3) pupillary reactivity
(4) hypoxia
(5) hypotension
(6) CT classification (from I to VI)
(7) traumatic subarachnoid hemorrhage (SAH)
(8) epidural hematoma
(9) serum glucose in mmol/L
(10) hemoglobin in g/dL
|
Parameter |
Finding |
Points |
|
age in years |
< 30 years |
0 |
|
|
30 to 39 |
1 |
|
|
40 to 49 |
2 |
|
|
50 to 59 |
3 |
|
|
60 to 69 |
4 |
|
|
>= 70 years |
5 |
|
motor score |
none or extension |
6 |
|
|
abnormal flexion |
4 |
|
|
normal flexion |
2 |
|
|
localizes or obeys |
0 |
|
|
untestable or missing |
3 |
|
pupillary reactivity |
2 |
0 |
|
|
1 |
2 |
|
|
0 |
4 |
|
hypoxia |
yes |
1 |
|
|
suspected |
1 |
|
|
no |
0 |
|
hypotension |
yes |
2 |
|
|
suspected |
2 |
|
|
no |
0 |
|
CT classification |
I |
-2 |
|
|
II |
0 |
|
|
III or IV |
2 |
|
|
V or VI |
2 |
|
traumatic SAH |
yes |
2 |
|
|
no |
0 |
|
epidural hematoma |
yes |
-2 |
|
|
no |
0 |
|
glucose |
< 6 mmol/L |
0 |
|
|
6 to 8.9 |
1 |
|
|
9 to 11.9 |
2 |
|
|
12 to 14.9 |
3 |
|
|
>= 15 mmol/L |
4 |
|
hemoglobin |
< 9 g/dL |
3 |
|
|
9 to 11.9 |
2 |
|
|
12 to 14.9 |
1 |
|
|
>= 15.0 |
0 |
core score =
= (points for age) + (points for motor score) + (points for pupillary reactivity)
extended score =
= (core score) + (points for hypoxia) + (points for hypotension) + (points for CT class) + (points for traumatic SAH) + (points for epidural hematoma)
lab score =
= (extended score) + (points for glucose) + (points for hemoglobin)
X for mortality using core score =
= (0.275 * (core score)) - 2.55
Y for mortality using extended score =
= (0.256 * (extended score)) - 2.98
Z for mortality using lab score =
= (0.216 * (lab score)) - 3.42
A for unfavorable outcome using core score =
= (0.299 * (core score)) - 1.62
B for unfavorable outcome using extended score =
= (0.276 * (lab score)) - 2.10
C for unfavorable outcome using lab score =
= (0.257 * (lab score) - 2.82
probability of outcome =
= 1 / (1 + EXP((-1) * (value)))
Purpose: To evaluate a patient with traumatic brain injury using the prognostic scores of Steyerberg et al.
Specialty: Surgery, orthopedic, Emergency Medicine, Critical Care, Surgery, general, Otolaryngology
Objective: severity, prognosis, stage
ICD-10: S06,
