• World Neurosurg · Jun 2019

    Prognostic predictors of early outcome and discharge status in patients undergoing decompressive craniectomy following severe traumatic brain injury.

    • Runfa Tian, Weiming Liu, Jinqian Dong, Ji Zhang, Long Xu, Bin Zhang, Xiaogang Tao, Jingsheng Li, and Baiyun Liu.
    • Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing, People's Republic of China; China National Clinical Research Center for Neurological Diseases, Beijing, People's Republic of China; Beijing Key Laboratory of Central Nervous System Injury, Beijing, People's Republic of China; Neurotrauma Laboratory, Beijing Neurosurgical Institute, Capital Medical University, Beijing, People's Republic of China.
    • World Neurosurg. 2019 Jun 1; 126: e101-e108.

    ObjectiveAlthough several prognostic factors for traumatic brain injury (TBI) have been evaluated, a useful predictive scoring model for the outcomes has not been developed for patients with severe TBI who undergo decompressive craniectomy (DC). The aim of the present study was to determine independent predictors and develop a multivariate logistic regression equation to predict the early outcome and discharge status for patients with severe TBI who have undergone DC.MethodsA total of 13 different variables were evaluated. The data from all 278 patients with severe TBI who had undergone DC in the present study were retrospectively evaluated from July 2011 to June 2017. Using univariate, multiple logistic regression and prognostic regression scoring equations it was possible to draw receiver operating characteristic curves to predict the early outcomes and discharge status after TBI.ResultsWe found that younger age (P = 0.012), no significant medical history (P = 0.044), diameter of both pupils <4 mm (P = 0.032), higher admission Glasgow coma scale score (P = 0.004), no tracheotomy (P < 0.001), and DC for severe TBI were associated with a favorable early outcome and discharge status. Using receiver operating characteristic curves to predict the probability of a favorable outcome, the sensitivity was 80.0% and the specificity was 79.5%.ConclusionsOur preliminary findings have shown that 5 variables can be used as independent predictors in assessing the early outcome and discharge status for patients with severe TBI after DC.Copyright © 2019. Published by Elsevier Inc.

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