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Prognostic calculator

Prognostic Calculator Based on extensive prognostic analysis the IMPACT investigators have developed prognostic models for predicting 6 month outcome in adult patients with moderate to severe head injury (Glasgow Coma Scale <=12) on admission. By entering the characteristics into the calculator, the models will provide an estimate of the expected outcome at 6 months. We present three models of increasing complexity (Core, Core + CT, Core + CT + Lab). These models were developed and validated in collaboration with the CRASH trial collaborators on large numbers of individual patient data (the IMPACT database). The models discriminate well, and are particularly suited for purposes of classification and characterization of large cohorts of patients. Extreme caution is required when applying the estimated prognosis to individual patients.

 

Prediction models for 6 month outcome after TBI

Admission Characteristics   Value
Core 
Age (14-99 years)
Motor Score
Pupils
Core+CT 
Hypoxia
Hypotension
CT Classification
tSAH on CT
Epidural mass on CT
Core+CT+Lab 
Glucose (3-20 mmol/L)
Hb (6-17 g/dL)
  

This model predicts outcome in the following patients:

Adults with head injury, Glasgow Coma Scale 12 or less.

 

Reference

  • Calculation of the linear predictor and probability of mortality / unfav outcome
    Coefficients model fit 2006.
  • Predicting outcome after traumatic brain injury: Development and international validation of prognostic scores based on admission characteristics.
    Steyerberg EW, Mushkudiani N, Perel P, Butcher I, Lu J, McHugh GS, Murray GD, Marmarou A, Roberts I, Habbema JD, Maas AI.
    PLoS Med. 2008 August; 5(8): e165.
    Grant support was provided by NIH NS 42691.

 

Legal statement

The sequential prediction models may be used as an aid to estimate 6 month outcome in patients with severe or moderate traumatic brain injury (TBI). However, the prediction rule can only complement, never replace, clinical judgment and can therefore be used only as a decision-support system.

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