Predicting outcome in severe traumatic brain injury using a simple prognostic model.

Autor:	Sobuwa S; Department of Emergency Medical Sciences, Faculty of Health and Wellness Sciences, Cape Peninsula University of Technology, Cape Town, South Africa. simpiwesobuwa@gmail.com., Hartzenberg HB, Geduld H, Uys C
Jazyk:	angličtina
Zdroj:	South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde [S Afr Med J] 2014 Jun 17; Vol. 104 (7), pp. 492-4. Date of Electronic Publication: 2014 Jun 17.
DOI:	10.7196/samj.7720
Abstrakt:	Background: Several studies have made it possible to predict outcome in severe traumatic brain injury (TBI) making it beneficial as an aid for clinical decision-making in the emergency setting. However, reliable predictive models are lacking for resource-limited prehospital settings such as those in developing countries like South Africa. Objective: To develop a simple predictive model for severe TBI using clinical variables in a South African prehospital setting. Methods: All consecutive patients admitted at two level-one centres in Cape Town, South Africa, for severe TBI were included. A binary logistic regression model was used, which included three predictor variables: oxygen saturation (SpO₂), Glasgow Coma Scale (GCS) and pupil reactivity. The Glasgow Outcome Scale was used to assess outcome on hospital discharge. Results: A total of 74.4% of the outcomes were correctly predicted by the logistic regression model. The model demonstrated SpO₂ (p=0.019), GCS (p=0.001) and pupil reactivity (p=0.002) as independently significant predictors of outcome in severe TBI. Odds ratios of a good outcome were 3.148 (SpO₂ ≥ 90%), 5.108 (GCS 6 - 8) and 4.405 (pupils bilaterally reactive). Conclusion: This model is potentially useful for effective predictions of outcome in severe TBI.
Databáze:	MEDLINE
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