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Severe head injuries: An outcome prediction and survival analysis

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Abstract

Objective

To identify the predictors determined early after admission and associated with unfavorable outcome or early (within 48 h) death after severe head injury.

Design

Prospective cohort study.

Setting

A neurosurgical intensive care unit in a university hospital.

Patients

198 consecutive comatose patients hospitalized from 1989 to 1992.

Results

Logistic regression showed that a combination of age, best motor response score from the Glasgow Coma Scale, and hypoxia provided a good prediction model of unfavorable outcome (sensitivity=0.93). The length of participation of survivors was 6 to 61 months (median 27.1). The Cox model demonstrated age, motor score less than 3, mydriasis, and hypoxia as poor prognosis factors.

Conclusions

Clinicians can determine the odds of a good outcome from the combination of three easily measurable factors using a simple diagram constructed from logistic regression. Survival analysis showed that motor score adjusted values greater than 3 had the same prognosis.

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Correspondence to P. Combes.

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Combes, P., Fauvage, B., Colonna, M. et al. Severe head injuries: An outcome prediction and survival analysis. Intensive Care Med 22, 1391–1395 (1996). https://doi.org/10.1007/BF01709556

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Key words

  • Head injury
  • Prognosis
  • Trauma severity
  • Grading system
  • Logistic regression model
  • Cox regression analysis