Surviving Penetrating Injury to the Brain (SPIN) Score

Description

Muehlschlegel et al reported the Surviving Penetrating Injury to the Brain (SPIN) Score for evaluating a patient with an acute civilian penetrating brain injury. This can help to identify a patient who is more likely to survive. The authors are from the University of Massachusetts, Massachusetts General Hospital, Brigham & Women's Hospital, the University of Maryland and Yale University.

Patient selection: civilian penetrating brain injury

Parameters:

(1) motor component of the Glasgow coma scale (GCS)

(2) pupils

(3) self-inflicted wound

(4) transferred

(5) sex

(6) injury severity score (ISS)

(7) INR

Parameter	Finding	Points
motor component GCS	6	9
	1 to 5	0
pupils	nonreactive bilaterally	0
	unequal	4
	globe rupture, nonvisual	6
	equal, react bilaterally	9
self-inflicted	no	4
	yes	0
transferred	no	0
	yes	4
sex	male	0
	female	4
ISS	<= 24	10
	25 to 40	5
	41 to 55	1
	>= 56	0
INR	<= 1.3	12
	1.4 to 2.0	6
	>= 2.1	0

total score =

= SUM(points for all of the parameters)

Interpretation:

• minimum score: 0

• maximum score: 52

• The higher the score the better the survival.

Score	Survival
>= 35	98%
30 to 34	78-80%
26 to 29	45 to 54%
21 to 25	10 to 15%
<= 20	1.5 to 3%

Performance:

• The authors claim an area under the ROC curve of 0.96.

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Surviving Penetrating Injury to the Brain (SPIN) Score

Description

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