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Simple Model Can Predict Brain Injury Outcome

Age, motor score, pupil response help predict good and poor outcomes six months after trauma

WEDNESDAY, Aug. 6 (HealthDay News) -- Out of dozens of possible factors to predict six-month outcomes in patients following traumatic brain injury, using age, motor score and pupillary reactivity discriminated adequately between those with good and poor outcomes, according to research published in the August issue of PLoS Medicine.

Ewout W. Steyerberg, Ph.D., of Erasmus MC in Rotterdam, the Netherlands, and colleagues created prognostic models using 8,509 patients with moderate and severe traumatic brain injury using a database including patients from 11 studies, and validated their findings on an additional 6,681 patients. They considered 26 easily assessable characteristics, including education, hypoxia, and cause of injury.

According to the authors, the set of age, motor score and pupillary reactivity at admission contained the most prognostic information. Adding characteristics from computed tomography, issues such as hypotension and hypoxia, and glucose and hemoglobin readings could improve the performance of this model, the report indicates.

"We now have new prognostic models for traumatic brain injury developed from large numbers of patients, which have been externally validated to allow prediction between favorable or unfavorable outcome at six months. These models may provide useful additional information in regard to clinical decision making and the counseling of patients' relatives, but it must be remembered that their outcomes apply to populations -- and so great caution is needed if applying them to individual patients," write Neil H. Young and Peter J.D. Andrews of the Western General Hospital in Edinburgh, U.K., in an accompanying editorial.

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