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      Multivariable prognostic analysis in traumatic brain injury: results from the IMPACT study.

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          Abstract

          We studied the prognostic value of a wide range of conventional and novel prognostic factors on admission after traumatic brain injury (TBI) using both univariate and multivariable analysis. The outcome measure was Glasgow Outcome Scale at 6 months after injury. Individual patient data were available on a cohort of 8686 patients drawn from eight randomized controlled trials and three observational studies. The most powerful independent prognostic variables were age, Glasgow Coma Scale (GCS) motor score, pupil response, and computerized tomography (CT) characteristics, including the Marshall CT classification and traumatic subarachnoid hemorrhage. Prothrombin time was also identified as a powerful independent prognostic factor, but it was only available for a limited number of patients coming from three of the relevant studies. Other important prognostic factors included hypotension, hypoxia, the eye and verbal components of the GCS, glucose, platelets, and hemoglobin. These results on prognostic factors will underpin future work on the IMPACT project, which is focused on the development of novel approaches to the design and analysis of clinical trials in TBI. In addition, the results provide pointers to future research, including further analysis of the prognostic value of prothrombin time, and the evaluation of the clinical impact of intervening aggressively to correct abnormalities in hemoglobin, glucose, and coagulation.

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          Author and article information

          Journal
          J Neurotrauma
          Journal of neurotrauma
          Mary Ann Liebert Inc
          0897-7151
          0897-7151
          Feb 2007
          : 24
          : 2
          Affiliations
          [1 ] Public Health Sciences, University of Edinburgh Medical School, Edinburgh, United Kingdom. Gordon.Murray@ed.ac.uk
          Article
          10.1089/neu.2006.0035
          17375997
          37a20021-883e-4fd2-805c-3f216e4aaf73
          History

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