naa a22 4500 51079923X CHVBK 20180411083347.0 cr unu---uuuuu 180411e20130801xx s 000 0 eng 10.1007/s12028-012-9795-9 doi (NATIONALLICENCE)springer-10.1007/s12028-012-9795-9 Outcome Prediction in Moderate and Severe Traumatic Brain Injury: A Focus on Computed Tomography Variables [Elektronische Daten] [Bram Jacobs, Tjemme Beems, Ton van der Vliet, Arie van Vugt, Cornelia Hoedemaekers, Janneke Horn, Gaby Franschman, Ian Haitsma, Joukje van der Naalt, Teuntje Andriessen, George Borm, Pieter Vos] Background: With this study we aimed to design validated outcome prediction models in moderate and severe traumatic brain injury (TBI) using demographic, clinical, and radiological parameters. Methods: Seven hundred consecutive moderate or severe TBI patients were included in this observational prospective cohort study. After inclusion, clinical data were collected, initial head computed tomography (CT) scans were rated, and at 6months outcome was determined using the extended Glasgow Outcome Scale. Multivariate binary logistic regression analysis was applied to evaluate the association between potential predictors and three different outcome endpoints. The prognostic models that resulted were externally validated in a national Dutch TBI cohort. Results: In line with previous literature we identified age, pupil responses, Glasgow Coma Scale score and the occurrence of a hypotensive episode post-injury as predictors. Furthermore, several CT characteristics were associated with outcome; the aspect of the ambient cisterns being the most powerful. After external validation using Receiver Operating Characteristic (ROC) analysis our prediction models demonstrated adequate discriminative values, quantified by the area under the ROC curve, of 0.86 for death versus survival and 0.83 for unfavorable versus favorable outcome. Discriminative power was less for unfavorable outcome in survivors: 0.69. Conclusions: Outcome prediction in moderate and severe TBI might be improved using the models that were designed in this study. However, conventional demographic, clinical and CT variables proved insufficient to predict disability in surviving patients. The information that can be derived from our prediction rules is important for the selection and stratification of patients recruited into clinical TBI trials. Springer Science+Business Media New York, 2012 Moderate traumatic brain injury nationallicence Severe traumatic brain injury nationallicence Outcome nationallicence Predictionmodel nationallicence CT-scan nationallicence Head injury nationallicence Jacobs Bram Department of Neurology (935), Radboud University Nijmegen Medical Centre (RUNMC), P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands aut Beems Tjemme Department of Neurosurgery (931), Radboud University Nijmegen Medical Centre, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands aut van der Vliet Ton Department of Radiology, RUNMC, Nijmegen, The Netherlands aut van Vugt Arie Department of Emergency Medicine, RUNMC, Nijmegen, The Netherlands aut Hoedemaekers Cornelia Department of Intensive Care Medicine (632), Radboud University Nijmegen Medical Centre, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands aut Horn Janneke Department of Intensive Care Medicine, Academic Medical Centre, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands aut Franschman Gaby Department of Anesthesiology, VU University Medical Centre, Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands aut Haitsma Ian Department of Neurosurgery, Erasmus Medical Centre, Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands aut van der Naalt Joukje Department of Neurology, University Medical Centre Groningen, University of Groningen, P.O. Box 30.001, 9700 RB, Groningen, The Netherlands aut Andriessen Teuntje Department of Neurology (935), Radboud University Nijmegen Medical Centre (RUNMC), P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands aut Borm George Department of Epidemiology, Biostatistics and HTA (133), Radboud University Nijmegen Medical Centre, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands aut Vos Pieter Department of Neurology (935), Radboud University Nijmegen Medical Centre (RUNMC), P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands aut Neurocritical Care Springer US; http://www.springer-ny.com 19/1(2013-08-01), 79-89 1541-6933 19:1<79 2013 19 12028 https://doi.org/10.1007/s12028-012-9795-9 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s12028-012-9795-9 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Jacobs Bram Department of Neurology (935), Radboud University Nijmegen Medical Centre (RUNMC), P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands aut NATIONALLICENCE 700 1- Beems Tjemme Department of Neurosurgery (931), Radboud University Nijmegen Medical Centre, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands aut NATIONALLICENCE 700 1- van der Vliet Ton Department of Radiology, RUNMC, Nijmegen, The Netherlands aut NATIONALLICENCE 700 1- van Vugt Arie Department of Emergency Medicine, RUNMC, Nijmegen, The Netherlands aut NATIONALLICENCE 700 1- Hoedemaekers Cornelia Department of Intensive Care Medicine (632), Radboud University Nijmegen Medical Centre, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands aut NATIONALLICENCE 700 1- Horn Janneke Department of Intensive Care Medicine, Academic Medical Centre, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands aut NATIONALLICENCE 700 1- Franschman Gaby Department of Anesthesiology, VU University Medical Centre, Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands aut NATIONALLICENCE 700 1- Haitsma Ian Department of Neurosurgery, Erasmus Medical Centre, Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands aut NATIONALLICENCE 700 1- van der Naalt Joukje Department of Neurology, University Medical Centre Groningen, University of Groningen, P.O. Box 30.001, 9700 RB, Groningen, The Netherlands aut NATIONALLICENCE 700 1- Andriessen Teuntje Department of Neurology (935), Radboud University Nijmegen Medical Centre (RUNMC), P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands aut NATIONALLICENCE 700 1- Borm George Department of Epidemiology, Biostatistics and HTA (133), Radboud University Nijmegen Medical Centre, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands aut NATIONALLICENCE 700 1- Vos Pieter Department of Neurology (935), Radboud University Nijmegen Medical Centre (RUNMC), P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands aut NATIONALLICENCE 773 0- Neurocritical Care Springer US; http://www.springer-ny.com 19/1(2013-08-01), 79-89 1541-6933 19:1<79 2013 19 12028 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer