PMID- 30213562
OWN - NLM
STAT- MEDLINE
DCOM- 20190523
LR  - 20190523
IS  - 1879-0267 (Electronic)
IS  - 0020-1383 (Linking)
VI  - 50
IP  - 1
DP  - 2019 Jan
TI  - Comparison of two simple models for prediction of short term mortality in 
      patients after severe traumatic brain injury.
PG  - 65-72
LID - S0020-1383(18)30475-3 [pii]
LID - 10.1016/j.injury.2018.08.022 [doi]
AB  - INTRODUCTION: The subscale motor score of Glasgow Coma Scale (msGCS) and the 
      Abbreviated Injury Score of head region (HAIS) are validated prognostic factors 
      in traumatic brain injury (TBI). The aim was to compare the prognostic 
      performance of a HAIS-based prediction model including HAIS, pupil reactivity and 
      age, and the reference prediction model including msGCS in emergency department 
      (ED), pupil reactivity and age. METHODS: Secondary analysis of a prospective 
      epidemiological study including patients after severe TBI (HAIS > 3) with 
      follow-up from the time of accident until 14 days or earlier death was performed 
      in Switzerland. Performance of prediction, based on accuracy of discrimination 
      [area under the receiver-operating curve (AUROC)], calibration (Hosmer-Lemeshow 
      test) and validity (bootstrapping with 2000 repetitions to correct) for optimism 
      of the two prediction models were investigated. A non-inferiority approach was 
      performed and an a priori threshold for important differences was established. 
      RESULTS: The cohort included 808 patients [median age 56 inter-quartile range 
      (IQR) 33-71, median motor part of GCS in ED 1 (1-6), abnormal pupil reactivity 
      29.0%] with a death rate of 29.7% at 14 days. The accuracy of discrimination was 
      similar (AUROC HAIS-based prediction model: 0.839; AUROC msGCS-based prediction 
      model: 0.826, difference of the 2 AUROC 0.013 (-0.007 to 0.037). A similar 
      calibration was observed (Hosmer-Lemeshow X(2) 11.64, p = 0.168 vs. 
      Hosmer-Lemeshow X(2) 8.66, p = 0.372). Internal validity of HAIS-based prediction 
      model was high (optimism corrected AUROC: 0.837). CONCLUSIONS: Performance of 
      prediction for short-term mortality after severe TBI with HAIS-based prediction 
      model was non-inferior to reference prediction model using msGCS as predictor.
CI  - Copyright (c) 2018 Elsevier Ltd. All rights reserved.
FAU - Rached, Mohamed A K B
AU  - Rached MAKB
AD  - Division of Anaesthesiology, University Hospitals of Geneva (HUG), Switzerland. 
      Electronic address: mohk@hcuge.ch.
FAU - Gaudet, John G
AU  - Gaudet JG
AD  - Division of Anaesthesiology, University Hospitals of Geneva (HUG), Switzerland.
FAU - Delhumeau, Cecile
AU  - Delhumeau C
AD  - Division of Anaesthesiology, University Hospitals of Geneva (HUG), Switzerland.
FAU - Walder, Bernhard
AU  - Walder B
AD  - Division of Anaesthesiology, University Hospitals of Geneva (HUG), Switzerland.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
DEP - 20180903
PL  - Netherlands
TA  - Injury
JT  - Injury
JID - 0226040
SB  - IM
MH  - Adult
MH  - Aged
MH  - Area Under Curve
MH  - Brain Injuries, Traumatic/*mortality
MH  - Female
MH  - *Glasgow Coma Scale
MH  - Humans
MH  - Injury Severity Score
MH  - Male
MH  - Middle Aged
MH  - Predictive Value of Tests
MH  - Prognosis
MH  - Prospective Studies
MH  - Reproducibility of Results
OTO - NOTNLM
OT  - Abbreviated Injury Score
OT  - Age
OT  - Calibration
OT  - Discrimination
OT  - Glasgow Coma Scale
OT  - Head injury
OT  - Prognosis
OT  - Pupil reactivity
EDAT- 2018/09/15 06:00
MHDA- 2019/05/24 06:00
CRDT- 2018/09/15 06:00
PHST- 2018/04/23 00:00 [received]
PHST- 2018/08/06 00:00 [revised]
PHST- 2018/08/23 00:00 [accepted]
PHST- 2018/09/15 06:00 [pubmed]
PHST- 2019/05/24 06:00 [medline]
PHST- 2018/09/15 06:00 [entrez]
AID - S0020-1383(18)30475-3 [pii]
AID - 10.1016/j.injury.2018.08.022 [doi]
PST - ppublish
SO  - Injury. 2019 Jan;50(1):65-72. doi: 10.1016/j.injury.2018.08.022. Epub 2018 Sep 3.