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ORIGINAL ARTICLE
Year : 2017  |  Volume : 4  |  Issue : 3  |  Page : 124-128

Traumatic brain injury predictive value of common intensive care severity scores


Department of Critical Care Medicine, El-Helal Hospital, Cairo, Egypt

Correspondence Address:
Mahmoud Kenawi
Cairo University Hospitals, Cairo, 35855
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/roaic.roaic_90_16

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Background Traumatic Brain Injury (TBI) causes a severe toll on society as a leading cause of mortality worldwide and the major cause of disability among young adults. The prognosis after TBI had been particularly challenging to predict, with limited availability of robust prognostic models. Aim To evaluate the usefulness of the acute physiology and chronic health evaluation II (APACHE II), simplified acute physiology score II (SAPS II) and sequential organ failure assessment (SOFA) scores compared to simpler models based on age and Glasgow coma scale (GCS) in predicting a six-month mortality of patients with moderate to severe traumatic brain injury (TBI) in the intensive care unit (ICU). Methods A prospective cohort study conducted on acute TBI patients admitted to ICU at EL-HELAL trauma Centre and KASR AL AINI university hospital, Egypt during the period from August 2014 to April 2015. All patients were followed-up for 6 months from the day of admission. Patients were divided into two groups (survivors and non-survivors). Results A total of 104 patients were enrolled. Mean age was 37±17.16 years. The overall six-month mortality was 25 patients (24.4%). The univariate analysis showed that APACHE II, SAPS II, SOFA, GCS, and age had a significant statistical difference regarding mortality between both groups (P-value < 0.05) and the optimal cut-off point as mortality indicator was 14, 26, 4, 9 and 49, respectively with area under the curve (AUC) 0.88, 0.87, 0.83, 0.80 and 0.79, respectively. Multivariate analysis using logistic regression found that only age and GCS had a statistically significant impact on outcome (P-value; 0.001, 0.022, respectively). Conclusions A simple prognostic model based only on GCS and age displayed good predictor for six-month mortality of ICU treated patients with TBI. The use of the more complex scoring systems (APACHE II, SAPS II and SOFA) added little to the prognostic performance.


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