IMPACT Score for Traumatic Brain Injury: Validation of the Prognostic Tool in a Spanish Cohort

Egea-Guerrero, Juan José; Rodríguez-Rodríguez, A.; Gordillo-Escobar, E.; Fernández-Delgado, Esperanza; Martínez-Roldán, Ángela; Roldán-Reina, A.J.; Durán-Martínez, Pilar; Vega-Ríos, Enrique de; Freire-Aragón, M.D.; Vilches-Arenas, Angel; Murillo-Cabezas, Francisco; Quintana-Díaz, Manuel

doi:10.1097/htr.0000000000000292

Cited by 12 publications

(10 citation statements)

References 38 publications

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“…The maximum age of the patients was 81 years with median age of 33 years. This result is consistent with the study done by Egea-Guerrero et al 11 which showed median age of 41 years. Panczykowski et al 12 and Olivecrona et al 13 did their study on adult patients with severe TBI who had mean ages of 37.8 and 35.5 years respectively.…”

Section: Discussionsupporting

confidence: 93%

“…Similarly, the overall unfavorable outcome and mortality observed in our study was 28.8% and 17.3% respectively. This is consistent with the study done by Egea-Guerrero et al 11 which showed unfavorable outcome and mortality as 25.5% and 16.2% respectively in patients with moderate to severe TBI. In a study done by Panczykowski et al 12 in a cohort of severe TBI patients, 73% had unfavorable outcome and 41% had mortality in 6 months.…”

Section: Discussionsupporting

confidence: 93%

“…4,10 In this prospective validation study from our center, all iterations of the IMPACT model demonstrated good prediction of both 6-month unfavorable neurologic outcome and mortality. 4,10 In our study, among 112 patients, 80.6% were males showing male preponderance which was similar in study done by Egea-Guerrero et al, 11 Wong et al and Kamal et al 15 This emphasizes that the incidence of moderate to severe TBI is more in male population. The minimum age of the patient enrolled was 18 years.…”

Section: Discussionsupporting

confidence: 89%

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Prognostication of Traumatic Brain Injury using International Mission for Prognosis and Analysis of Clinical Trials in Traumatic Brain Injury score in Nepalese Cohort

Jha

Khambu

et al. 2021

Nep J Neurosci

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Introduction: Traumatic brain injury disease of major importance globally. Prognostic models are useful for making decisions in the clinical practice. The aim of this study was to assess the accuracy of International Mission for Prognosis and Analysis of Clinical Trials in TBI (IMPACT) score in predicting outcome in moderate to severe TBI at 3 months. Materials and Methods: All patients admitted to National Trauma Center, National Academy of Medical Sciences with moderate to severe traumatic brain injury from February 2020 to February 2021 were included in the study. IMPACT scores (core/extended core/ lab) were recorded separately at admission. Outcome was measured with Glasgow Outcome Scale (GOS) at the time of discharge and at six months. Correlation between observed and predicted outcomes was evaluated by Pearson’s correlation coefficient (r). Sensitivity and specificity were plotted in the receiver-operating characteristic (ROC) curve, and the area under the curve (AUC) was calculated to determine the discrimination ability of this prognostic model. Results: A total of 112 patients were enrolled in the study. Eighty (71.4 %) patients had moderate and 32 (28.57 %) had severe TBI. The median age was 33 years with male preponderance (M: F=4:1). Thirty three (29.5 %) patients died within 6 months of TBI, and 38 (33.9 %) patients had an unfavorable outcome. Pearson correlation coefficient showed good correlation between observed and predicted outcomes. Hosmer-Lemeshow test showed good model fit for IMPACT core, IMPACT extended and IMPACT lab in diagnosing mortality and unfavorable outcome in six months (p>0.05). The ROC curve indicated that all 3 models could accurately discriminate between favorable and unfavorable outcomes, as well as between survival and mortality (unfavorable outcome AUC= 0.905, 0.940, 0.955; mortality AUC= 0.875, 0.914, 0.917 respectively) in our patient population. Conclusion: The IMPACT score is a good prognostic model to predict 6-month outcomes in moderate to severe TBI at admission in Nepalese patient population. Among the three IMPACT models, IMPACT lab has the greatest discriminating ability.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 89%

See 1 more Smart Citation

Prognostication of Traumatic Brain Injury using International Mission for Prognosis and Analysis of Clinical Trials in Traumatic Brain Injury score in Nepalese Cohort

Jha

Khambu

et al. 2021

Nep J Neurosci

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“…Different studies have been conducted into the validation of these models. In these studies, patients with severe and moderate traumatic brain injury have been evaluated, and use of the different models and scores has shown that their performance and sensitivity is high [19][20][21][22][23].…”

Section: Discussionmentioning

confidence: 99%

Outcomes of traumatic brain injury: the prognostic accuracy of various scores and models

Charry¹,

Navarro-Parra²,

Solano³

et al. 2018

Neurol Neurochir Pol.

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Introduction. Traumatic Brain Injury (TBI) is a worldwide health problem, and is a pathology that causes significant mortality and disability in Latin America. Different scores and prognostic models have been developed in order to predict the neurologi-cal outcomes of patients. We aimed to test the prognostic accuracy of the Marshall CT classification system, the Rotterdam CT scoring system, and the IMPACT and CRASH models, in predicting 6-month mortality and 6-month unfavourable outcomes in a cohort of trauma patients with TBI in a university hospital in Colombia. Methods. We analysed 309 patients with significant TBI who were treated in a regional trauma centre in Colombia over a two year period. Bivariate and multivariate analyses were undertaken. The discriminatory power of each model, as well as its accuracy and precision, were assessed by logistic regression and AUC. Shapiro Wilks, chi2 and Wilcoxon test were used to compare the actual outcomes in the cohort against the predicted outcomes. Results. The median age was 32 years, and 77.67% were male. All four prognostic models showed good accuracy in predicting outcomes. The IMPACT model had the greatest accuracy in predicting an unfavourable outcome (AUC 0.864; 95% CI 0.819-0.909) and in predicting mortality (AUC 0.902; 95% CI 0.862-0.943) in patients with TBI. Conclusion. All four prognostic models are applicable to eligible TBI patients in Colombia. The IMPACT model was shown to be more accurate than the other prognostic models, and had a higher sensitivity in predicting 6-month mortality and 6month unfavourable outcomes in patients with TBI in a university hospital in Colombia.

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“…In addition to evaluating the association between sleep apnea and occurrence of brain injuries, we evaluated the association between sleep apnea and severities of brain injuries. Information regarding Glasgow Coma Scale or IMPACT score (20) was unavailable in the NHIRD. Therefore, we used intensive care unit (ICU) use and mortality following a brain injury episode as our research outcomes.…”

Section: Outcome and Relevant Variablesmentioning

confidence: 99%

Sleep apnea and risk of traumatic brain injury and associated mortality and healthcare costs: a population-based cohort study

et al. 2019

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Background: The objective of this study was aimed to investigate whether sleep apnea patients had a higher risk of traumatic brain injury. Methods: Data were collected from the Taiwan Longitudinal Health Insurance Database during the period of 2000-2012. The study cohort comprised 6,456 patients aged ≥20 years with a first diagnosis of sleep apnea. The primary outcome was the incidence of traumatic brain injury. Kaplan-Meier survival analysis and Cox proportional-hazards modeling were used.Results: After adjustments for associated comorbidities and hypnotic medications, sleep apnea patients were associated with a 1.19-fold higher risk of traumatic brain injury (95% CI, 1.07-1.33) compared with patients without sleep apnea. Sleep apnea patients who took benzodiazepine (BZD) had a 1.30-fold increased risk of traumatic brain injury compared with patients without sleep apnea (95% CI, 1.14-1.49). However, this risk was not statistically significant, with a 1.03-fold risk of traumatic brain injury in sleep apnea patients without BZD use (95% CI, 0.84-1.25) compared with patients without sleep apnea. Compared with patients without sleep apnea, the risk of traumatic brain injury in sleep apnea patients aged 65-79 years old was higher (adjusted hazard ratio, 1.36; 95% CI, 1.06-1.74).Conclusions: Sleep apnea patients, regardless of hypnotic use, had a higher risk of traumatic brain injury compared with patients without sleep apnea.

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IMPACT Score for Traumatic Brain Injury: Validation of the Prognostic Tool in a Spanish Cohort

Cited by 12 publications

References 38 publications

Prognostication of Traumatic Brain Injury using International Mission for Prognosis and Analysis of Clinical Trials in Traumatic Brain Injury score in Nepalese Cohort

Prognostication of Traumatic Brain Injury using International Mission for Prognosis and Analysis of Clinical Trials in Traumatic Brain Injury score in Nepalese Cohort

Outcomes of traumatic brain injury: the prognostic accuracy of various scores and models

Sleep apnea and risk of traumatic brain injury and associated mortality and healthcare costs: a population-based cohort study

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