External validation of the GCS-Pupils Score as an outcome predictor after traumatic brain injury in adults: a single-center experience.
Acta Neurochir (Wien)
; 165(2): 289-297, 2023 02.
Article
en En
| MEDLINE
| ID: mdl-36484865
ABSTRACT
OBJECTIVE:
The GCS-Pupils (GCS-P) score is a recently described scoring system to aid outcome prediction in patients with traumatic brain injury (TBI). The aim of this study was to provide the first external validation of the GCS-P score by identifying independent predictors of outcome in TBI patients.METHODS:
Review of prospective adult (≥ 16 years) TBI database at a tertiary neurosurgical center with a catchment population of 1.5 million over a 12-month period commencing October 2016. Multivariate logistic regression was used to identify predictors of discharge destination and 30-day mortality.RESULTS:
Three hundred and fifty-eight patients were included. The median age was 60 years with a male predominance of 64%. The median GCS-P was 14 (interquartile range 12-15) and the commonest GCS-P category was mild (13-15; 238/358, 66%). Discharge destination was home in 69% of patients and rehab services or equivalent in 31%. Multivariate analysis identified age (p = 0.01), CT findings of an acute subdural hematoma (p = 0.01) or diffuse axonal injury (p = 0.02), and a neurosurgical operation (p = 0.02) as independent predictors of discharge destination. The 30-day mortality rate was 11%. Within the category of severe TBI (GCS-P ≤ 8), GCS-P was able to identify patients with a very high likelihood of 30-day mortality (GCS-P ≤ 4; 16/31, 52%). Multivariate analysis revealed the Charlson comorbidity score (p = 0.01), GCS-P (p = 0.02), and traumatic subarachnoid hemorrhage (p = 0.05) as independent predictors of mortality.CONCLUSION:
The GCS-P is a useful predictor of 30-day mortality, although its usefulness for other clinical outcomes remains to be proven.Palabras clave
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Lesiones Traumáticas del Encéfalo
Tipo de estudio:
Prognostic_studies
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Risk_factors_studies
Límite:
Adult
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Acta Neurochir (Wien)
Año:
2023
Tipo del documento:
Article
País de afiliación:
Reino Unido