Prognostic Value of The Glasgow Coma Scale And Pupil Reactivity in Traumatic Brain Injury Assessed Pre-Hospital And on Enrollment: An IMPACT Analysis

Marmarou, Anthony; Lü, Juan; Butcher, Isabella; McHugh, Gillian S; Murray, Gordon D.; Steyerberg, Ewout W.; Mushkudiani, Nino; Choi, Sung C.; Maas, Andrew I. R.

doi:10.1089/neu.2006.0029

Cited by 304 publications

(233 citation statements)

References 40 publications

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“…The majority of patient characteristics were similar at baseline, with the large exception that the craniectomy group included a higher percentage of participants with nonresponsive pupils than the standard of care group (27% vs 12%, respectively), which is an indicator of more severe prognosis. 36 The authors designated 20 mm Hg as their threshold for intracranial hypertension. While this value is generally accepted in pediatric studies, it has not received a Level I recommendation for the threshold for instituting therapy in adult populations.…”

Section: Cooper Et Al 2011mentioning

confidence: 99%

Traumatic brain injury in pediatric patients: evidence for the effectiveness of decompressive surgery

Appelboom

Zoller

Piazza

et al. 2011

FOC

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Traumatic brain injury (TBI) is the current leading cause of death in children over 1 year of age. Adequate management and care of pediatric patients is critical to ensure the best functional outcome in this population. In their controversial trial, Cooper et al. concluded that decompressive craniectomy following TBI did not improve clinical outcome of the analyzed adult population. While the study did not target pediatric populations, the results do raise important and timely clinical questions regarding the effectiveness of decompressive surgery in pediatric patients. There is still a paucity of evidence regarding the effectiveness of this therapy in a pediatric population, and there is an especially noticeable knowledge gap surrounding age-stratified interventions in pediatric trauma. The purposes of this review are to first explore the anatomical variations between pediatric and adult populations in the setting of TBI. Second, the authors assess how these differences between adult and pediatric populations could translate into differences in the impact of decompressive surgery following TBI.

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Section: Cooper Et Al 2011mentioning

confidence: 99%

Traumatic brain injury in pediatric patients: evidence for the effectiveness of decompressive surgery

Appelboom

Zoller

Piazza

et al. 2011

FOC

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“…These patients had a mean age of 47.2 (±26.4) years and a mean ISS of 20.9 (±4.6; range [16][17][18][19][20][21][22][23][24][25][26][27][28][29]. Almost two-third of these false negatives incurred extremity (66.7%) injuries, whereas only 39.6% of the other major trauma patients, the true positives, sustained extremity injuries (p=0.068).…”

Section: Resultsmentioning

confidence: 99%

“…Furthermore, the proposed model includes only one physiological item, i.e., the GCS. The GCS is a good predictor of brain injury [25]. The other physiological parameters, i.e., the systolic blood pressure and the respiratory rate, were excluded.…”

Section: Discussionmentioning

confidence: 99%

Prehospital identification of major trauma patients

Ocak

Sturms

Hoogeveen

et al. 2008

Langenbecks Arch Surg

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Background and aims Prehospital triage is aimed at getting the right patient to the right hospital. Evaluations on the performance of prehospital triage tools are scarce. This study examines the ability of the American College of Surgeons' Committee on Trauma (ACSCOT) triage guidelines to identify major trauma patients in a European trauma system. Furthermore, this study evaluates the predictive power of other prehospital measurements. Materials and methods Prehospital data of 151 minor (Injury Severity Score (ISS) 1-15) and 151 major trauma patients, (ISS>15) treated at a Dutch trauma center, were collected. Logistic regression analysis was used to identify predictors of major trauma patients. Results The major trauma patients particularly incurred severe head injuries (45.7%) and severe thorax injuries (21.9%). The ACSCOT guidelines had a sensitivity of 84.1% and a specificity of 77.5%. A new prehospital trauma triage model was constructed including nine predictors of major trauma. This model identified more major trauma patients than the ACSCOT (sensitivity 92.1%, p=0.023) and resulted in a comparable specificity (79.5%; p=0.711). Conclusion The new triage model outperforms the ACS COT triage guidelines in identifying major trauma patients in the prehospital setting. The new triage guidelines may improve patient outcomes but needs to be validated in a prospective study.

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“…Outcome prediction is not an easy task to achieve after HI, because of complexity of affecting the factors. We described two new predicting models with well described parameter by recent studies for affecting the prognosis of head injured patient (1,(3)(4)(5)(6)(7)(8)(9)(10)(11)(12). In differently, the most of these parameters used in our models were simplified present or absent for easy using.…”

Section: Discussionmentioning

confidence: 99%

“…(1,(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14). In the literature, more than one hundred recent studies, most of them from developed countries, were designed for predicting the prognosis after HI (15).…”

Section: Introductionmentioning

confidence: 99%