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Glasgow coma scale pupil score (GCS-P) and the hospital mortality in severe traumatic brain injury: analysis of 1,066 Brazilian patients
Background Pupil reactivity and the Glasgow Coma Scale (GCS) score are the most clinically relevant information to predict the survival of traumatic brain injury (TBI) patients. Objective We evaluated the accuracy of the GCS-Pupil score (GCS-P) as a prognostic index to predict hospital mortality i...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Thieme Revinter Publicações Ltda.
2023
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10232027/ https://www.ncbi.nlm.nih.gov/pubmed/37257465 http://dx.doi.org/10.1055/s-0043-1768671 |
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author | Bertotti, Melina Moré Martins, Evandro Tostes Areas, Fernando Zanela Vascouto, Helena Dresch Rangel, Norma Beatriz Melo, Hiago Murilo Lin, Katia Kupek, Emil Pizzol, Felipe Dal Golby, Alexandra J. Walz, Roger |
author_facet | Bertotti, Melina Moré Martins, Evandro Tostes Areas, Fernando Zanela Vascouto, Helena Dresch Rangel, Norma Beatriz Melo, Hiago Murilo Lin, Katia Kupek, Emil Pizzol, Felipe Dal Golby, Alexandra J. Walz, Roger |
author_sort | Bertotti, Melina Moré |
collection | PubMed |
description | Background Pupil reactivity and the Glasgow Coma Scale (GCS) score are the most clinically relevant information to predict the survival of traumatic brain injury (TBI) patients. Objective We evaluated the accuracy of the GCS-Pupil score (GCS-P) as a prognostic index to predict hospital mortality in Brazilian patients with severe TBI and compare it with a model combining GCS and pupil response with additional clinical and radiological prognostic factors. Methods Data from 1,066 patients with severe TBI from 5 prospective studies were analyzed. We determined the association between hospital mortality and the combination of GCS, pupil reactivity, age, glucose levels, cranial computed tomography (CT), or the GCS-P score by multivariate binary logistic regression. Results Eighty-five percent ( n = 908) of patients were men. The mean age was 35 years old, and the overall hospital mortality was 32.8%. The area under the receiver operating characteristic curve (AUROC) was 0.73 (0.70–0.77) for the model using the GCS-P score and 0.80 (0.77–0.83) for the model including clinical and radiological variables. The GCS-P score showed similar accuracy in predicting the mortality reported for the patients with severe TBI derived from the International Mission for Prognosis and Clinical Trials in TBI (IMPACT) and the Corticosteroid Randomization After Significant Head Injury (CRASH) studies. Conclusion Our results support the external validation of the GCS-P to predict hospital mortality following a severe TBI. The predictive value of the GCS-P for long-term mortality, functional, and neuropsychiatric outcomes in Brazilian patients with mild, moderate, and severe TBI deserves further investigation. |
format | Online Article Text |
id | pubmed-10232027 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Thieme Revinter Publicações Ltda. |
record_format | MEDLINE/PubMed |
spelling | pubmed-102320272023-06-01 Glasgow coma scale pupil score (GCS-P) and the hospital mortality in severe traumatic brain injury: analysis of 1,066 Brazilian patients Bertotti, Melina Moré Martins, Evandro Tostes Areas, Fernando Zanela Vascouto, Helena Dresch Rangel, Norma Beatriz Melo, Hiago Murilo Lin, Katia Kupek, Emil Pizzol, Felipe Dal Golby, Alexandra J. Walz, Roger Arq Neuropsiquiatr Background Pupil reactivity and the Glasgow Coma Scale (GCS) score are the most clinically relevant information to predict the survival of traumatic brain injury (TBI) patients. Objective We evaluated the accuracy of the GCS-Pupil score (GCS-P) as a prognostic index to predict hospital mortality in Brazilian patients with severe TBI and compare it with a model combining GCS and pupil response with additional clinical and radiological prognostic factors. Methods Data from 1,066 patients with severe TBI from 5 prospective studies were analyzed. We determined the association between hospital mortality and the combination of GCS, pupil reactivity, age, glucose levels, cranial computed tomography (CT), or the GCS-P score by multivariate binary logistic regression. Results Eighty-five percent ( n = 908) of patients were men. The mean age was 35 years old, and the overall hospital mortality was 32.8%. The area under the receiver operating characteristic curve (AUROC) was 0.73 (0.70–0.77) for the model using the GCS-P score and 0.80 (0.77–0.83) for the model including clinical and radiological variables. The GCS-P score showed similar accuracy in predicting the mortality reported for the patients with severe TBI derived from the International Mission for Prognosis and Clinical Trials in TBI (IMPACT) and the Corticosteroid Randomization After Significant Head Injury (CRASH) studies. Conclusion Our results support the external validation of the GCS-P to predict hospital mortality following a severe TBI. The predictive value of the GCS-P for long-term mortality, functional, and neuropsychiatric outcomes in Brazilian patients with mild, moderate, and severe TBI deserves further investigation. Thieme Revinter Publicações Ltda. 2023-05-31 /pmc/articles/PMC10232027/ /pubmed/37257465 http://dx.doi.org/10.1055/s-0043-1768671 Text en Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit ( https://creativecommons.org/licenses/by/4.0/ ) https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Bertotti, Melina Moré Martins, Evandro Tostes Areas, Fernando Zanela Vascouto, Helena Dresch Rangel, Norma Beatriz Melo, Hiago Murilo Lin, Katia Kupek, Emil Pizzol, Felipe Dal Golby, Alexandra J. Walz, Roger Glasgow coma scale pupil score (GCS-P) and the hospital mortality in severe traumatic brain injury: analysis of 1,066 Brazilian patients |
title | Glasgow coma scale pupil score (GCS-P) and the hospital mortality in severe traumatic brain injury: analysis of 1,066 Brazilian patients |
title_full | Glasgow coma scale pupil score (GCS-P) and the hospital mortality in severe traumatic brain injury: analysis of 1,066 Brazilian patients |
title_fullStr | Glasgow coma scale pupil score (GCS-P) and the hospital mortality in severe traumatic brain injury: analysis of 1,066 Brazilian patients |
title_full_unstemmed | Glasgow coma scale pupil score (GCS-P) and the hospital mortality in severe traumatic brain injury: analysis of 1,066 Brazilian patients |
title_short | Glasgow coma scale pupil score (GCS-P) and the hospital mortality in severe traumatic brain injury: analysis of 1,066 Brazilian patients |
title_sort | glasgow coma scale pupil score (gcs-p) and the hospital mortality in severe traumatic brain injury: analysis of 1,066 brazilian patients |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10232027/ https://www.ncbi.nlm.nih.gov/pubmed/37257465 http://dx.doi.org/10.1055/s-0043-1768671 |
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