A recent study suggests that there are multiple intracranial pathologies in traumatic brain injuries (TBIs) that can assist in predicting patient outcomes. The study, which was published in the European Journal of Trauma and Emergency Surgery, indicates that pathologies can be categorized by using Marshall Classification, the Abbreviated Injury Scale (AIS) dictionary, or traditional descriptive terms such as subarachnoid hemorrhage (SAH). Researchers report that the study assessed the prognostic value of AIS scores, the Marshall Classification, and various intracranial pathologies in TBI.
Researchers say they used logistic regression to analyze 802 TBI patients in the Trauma Audit and Research Network (TARN) database. Reportedly, a baseline model used age, Glasgow Coma Scale (GCS), papillary reactivity, cause of injury, and presence/absence of extracranial injury as predictors and survival at discharge as the outcome. According to the study, AIS score, Marshall Classification, and various intracranial pathologies including hemorrhage and SAH were added to assess the predicative strength of each variable and also to assess the improvement in the performance of the model.
The study’s results suggest that alone, neither the various AIS scores nor Marshall Classification exhibited a significant effect on patient outcome. Hemorrhage and its subtypes, such as SAH, were also not individually linked to outcome, the study says. Instead, the blending of AIS scores, Marshall Classification, and various intracranial pathologies in the prognostic models reportedly enhanced the performance of an early mortality prediction model in TBI patients.
Researchers add that the negative effect of brain swelling and brain stem injury on patient outcome compared to injuries such as SAH, requires improvement in the treatment of patients who have sustained these types of injuries.
Source: European Journal of Trauma and Emergency Surgery