Journal of neurotrauma
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Journal of neurotrauma · Oct 2022
Multicenter StudyPoCS Rule : Derivation and Validation of a Clinical Decision Rule for Early Prediction of Persistent Symptoms after a mild Traumatic Brain Injury.
Mild traumatic brain injury (mTBI) is a common problem. Depending on diagnostic criteria, 13 to 62% of those patients develop persistent post-concussion symptoms (PPCS). The main objective of this prospective multi-center study is to derive and validate a clinical decision rule (CDR) for the early prediction of PPCS. ⋯ The 7-day follow-up identified additional risk factors: headaches, sleep disturbance, fatigue, sensitivity to light, and RPQ ≥21. The PoCS Rule had a sensitivity of 91.4% and 89.6%, a specificity of 53.8% and 44.7% and a negative predictive value of 97.2% and 95.8% in the derivation and validation cohorts, respectively. The PoCS Rule will help emergency physicians quickly stratify the risk of PPCS in mTBI patients and better plan post-discharge resources.
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Journal of neurotrauma · Oct 2022
Multicenter Study Observational StudyVitamin D Deficiency and Prognosis after Traumatic Brain Injury with Intracranial Injury: A Multicenter Observational Study.
Vitamin D may be important for neuroprotection after traumatic brain injury (TBI) by modifying the inflammatory response. The objective of this study was to evaluate the association between vitamin D deficiency and functional and survival outcomes in patients with TBI and intracranial injury. This study was a prospective multi-center cohort study conducted on adult TBI patients, with intracranial hemorrhage or diffuse axonal injury confirmed by radiological examination, admitted to five participating emergency departments (EDs) from December 2018 to June 2020. ⋯ Good functional recovery was observed in 65.2% (395/606) of total population, and this proportion was significantly lower in the vitamin D deficiency group than the non-deficiency group (56.4 vs. 66.9%, p = 0.04, adjusted odds ratio (OR; 95% confidence interval [CI]): 0.56 (0.36-0.88)). Overall survival rate at 6 months after injury was 79.5% (434/546), and patients with vitamin D deficiency had significantly lower likelihood of survival at 6 months than patients without deficiency [75.0 vs. 80.3%, adjusted OR (95% CI): 0.59 (0.39-0.89)]. Vitamin D deficiency is associated with poor functional outcomes at hospital discharge and mortality at 6-months after injury in TBI patients with intracranial hemorrhage or diffuse axonal injury.