Tasaki et al identified risk factors for an unfavorable outcome following severe traumatic brain injury. These risk factors can be used in the outcome prediction model given in the previous section or as a simple risk score. The authors are from Osaka University in Japan.


Patient selection: traumatic brain injury with Glasgow coma score < 9 on admission or deterioration to < 9 within 12 hours after injury


Exclusions: brain dead on admission, hemorrhagic shock, alcohol-induced coma


Outcomes: favorable (good recovery or moderate disability) or unfavorable (persistent vegetative state or death)


Risk factors associated with 90-92% of patients having an unfavorable outcome):

(1) extensive subarachnoid hemorrhage

(2) absence of light reflex in both pupils


Additional risk factors:

(1) age >= 70 years of age

(2) intracranial pressure > 30 mm Hg

(3) midline shift > 12 mm


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