Int J Med Sci 2021; 18(7):1639-1647. doi:10.7150/ijms.54913

Research Paper

Clinical predictors of prognosis in patients with traumatic brain injury combined with extracranial trauma

Chengli Liu*, Jie Xie*, Xinshuang Xiao, Tianyu Li, Hui Li, Xiangjun Bai, Zhanfei Li, Wei Wang

Department of Traumatic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, P.R. China.
*These authors contributed equally to this manuscript.

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Citation:
Liu C, Xie J, Xiao X, Li T, Li H, Bai X, Li Z, Wang W. Clinical predictors of prognosis in patients with traumatic brain injury combined with extracranial trauma. Int J Med Sci 2021; 18(7):1639-1647. doi:10.7150/ijms.54913. Available from https://www.medsci.org/v18p1639.htm

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Abstract

Objective: The purpose of this study was to investigate whether routine blood tests on admission and clinical characteristics can predict prognosis in patients with traumatic brain injury (TBI) combined with extracranial trauma.

Methods: Clinical data of 182 patients with TBI combined with extracranial trauma from April 2018 to December 2019 were retrospectively collected and analyzed. Based on GOSE score one month after discharge, the patients were divided into a favorable group (GOSE 1-4) and unfavorable group (GOSE 5-8). Routine blood tests on admission and clinical characteristics were recorded.

Results: Overall, there were 48 (26.4%) patients with unfavorable outcome and 134 (73.6%) patients with favorable outcome. Based on multivariate analysis, independent risk factors associated with unfavorable outcome were age (odds ratio [OR], 1.070; 95% confidence interval [CI], 1.018-1.124; p<0.01), admission Glasgow Coma Scale (GCS) score (OR, 0.807; 95% CI, 0.675-0.965; p<0.05), heart rate (OR, 1.035; 95% CI, 1.004-1.067; p<0.05), platelets count (OR, 0.982; 95% CI, 0.967-0.997; p<0.05), and tracheotomy (OR, 15.201; 95% CI, 4.121-56.078; p<0.001). Areas under the curve (AUC) of age, admission GCS, heart rate, tracheotomy, and platelets count were 0.678 (95% CI, 0.584-0.771), 0.799 (95% CI, 0.723-0.875), 0.652 (95% CI, 0.553-0.751), 0.776 (95% CI, 0.692-0.859), and 0.688 (95% CI, 0.606-0.770), respectively.

Conclusions: Age, admission GCS score, heart rate, tracheotomy, and platelets count can be recognized as independent predictors of clinical prognosis in patients with severe TBI combined with extracranial trauma.

Keywords: prognosis, traumatic brain injury, multiple trauma, prognostic factor