User:KrabDave/Prognosis after traumatic brain injury

Prognosis after traumatic brain injury
Traumatic brain injury (TBI) is one of the leading causes of morbidity and mortality world wide. Prognosis after traumatic brain injury is complex subject. Usually prognosis after traumatic brain injury is measured in glasgow outcome scale extended (GOSE) at around 6 months after trauma. Traumatic brain injury could affect physical, mental and psychological wellbeing of the patient.

Prognosis prediction
Clasically, outcome prediction has been made using a dichotomized version of GOSE into death (GOSE 1) or not (GOSE 2-8), and favorable outcome (GOSE 5-8) or unfavorable outcome (GOS 1-4). Outcome prediction model has been an extensively studied subject, and while multiple prognostic models for TBI have accumulated over the last decades and none of them is widely used in clinical practice. In 2007-2008 the large cohort studies Corticosteroid Randomisation After Significant Head Injury (CRASH) and International Mission for Prognosis and Clinical Trial (IMPACT) were used to develop prognostic models. Both models have high discriminative ability as determined by the area under the receiver operator curve (AUROC) which is of around 0.8 in internal validation. Variables identified in the IMPACT study have been analyzed for their prognostic power and validated in many different cohorts. Age, injury severity, and computer tomography findings were found to have the highest prognostic power (as determined by their respective R² value).

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