A prognostic model for traumatic coma

Şt.I. Florian, A.L. Blaga, Zorinela Andraşoni
Clinica de Neurochirurgie Cluj-Napoca, Spitalul Clinic Judeţean de Urgenţă Cluj

Abstract

Aim. To develop a prognostic model for comatose patients with traumatic brain injuries based on several parameters which are easily obtained from these patients on admission. The accuracy of this model was compared with an early one obtained in 1998.

Material and method. This study represents a retrospective analysis of a group of 206 comatose patients with traumatic brain injuries admitted between 1st of January 2003 and 31st of December 2004 to the Department of Neurosurgery Cluj-Napoca. Among the 10 registered clinical and radiological parameters, only four parameters proved to be statistically significant for the prognostic model: age, pupillary aspect, GCS on admission and the brain injuries from the CT-scan. To analyze these data and the importance of each parameter for the prognostic, the statistical software EpiInfo 3.2.2 (2005 version) and the linear regression method were used.

Results. Besides the presentation of prognostic model and its performances, we compared the accuracy of this model with the one obtained in 1998, when the brain injuries were quantified without a CT-scan. The model obtained in 1998 applied to the 2004 group of patients predicted death in 102 of the 110 cases of the deceased and survival in 70 out of 96 cases of survivors; the model obtained in 2004 predicted correctly 96 out of 110 deaths and 82 out of 96 survivals. In the 2004 group of patients the best prediction of survival was obtained by the model which included CT scan evaluation of the brain injuries: 85.42% sensibility and 87.27% specificity, as compared with the previous model which did not use CT scan: 72.91% sensibility and 92.72% specificity. Conclusion. Introduction of the CT-scan for evaluation of the brain injuries improved the accuracy for prediction of survival of the patients with traumatic coma.

Key words: prognosis model, coma, traumatic brain injuries

Model prognostic în coma traumatică

Jurnalul Român de Anestezie Terapie intensivă 2007 Vol.14 Nr.1, 26-31