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Chinese Admission Warning Strategy for Predicting the Hospital Discharge Outcome in Patients with Traumatic Brain Injury

Objective: To develop and validate an admission warning strategy that incorporates the general emergency department indicators for predicting the hospital discharge outcome of patients with traumatic brain injury (TBI) in China. Methods: This admission warning strategy was developed in a primary coh...

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Autores principales: Zheng, Ruizhe, Zhuang, Zhongwei, Zhao, Changyi, Zhao, Zhijie, Yang, Xitao, Zhou, Yue, Pan, Shuming, Chen, Kui, Li, Keqin, Huang, Qiong, Wang, Yang, Ma, Yanbin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8880692/
https://www.ncbi.nlm.nih.gov/pubmed/35207247
http://dx.doi.org/10.3390/jcm11040974
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author Zheng, Ruizhe
Zhuang, Zhongwei
Zhao, Changyi
Zhao, Zhijie
Yang, Xitao
Zhou, Yue
Pan, Shuming
Chen, Kui
Li, Keqin
Huang, Qiong
Wang, Yang
Ma, Yanbin
author_facet Zheng, Ruizhe
Zhuang, Zhongwei
Zhao, Changyi
Zhao, Zhijie
Yang, Xitao
Zhou, Yue
Pan, Shuming
Chen, Kui
Li, Keqin
Huang, Qiong
Wang, Yang
Ma, Yanbin
author_sort Zheng, Ruizhe
collection PubMed
description Objective: To develop and validate an admission warning strategy that incorporates the general emergency department indicators for predicting the hospital discharge outcome of patients with traumatic brain injury (TBI) in China. Methods: This admission warning strategy was developed in a primary cohort that consisted of 605 patients with TBI who were admitted within 6 h of injury. The least absolute shrinkage and selection operator and multivariable logistic regression analysis were used to develop the early warning strategy of selected indicators. Two sub-cohorts consisting of 180 and 107 patients with TBI were used for the external validation. Results: Indicators of the strategy included three categories: baseline characteristics, imaging and laboratory indicators. This strategy displayed good calibration and good discrimination. A high C-index was reached in the internal validation. The multicenter external validation cohort still showed good discrimination C-indices. Decision curve analysis (DCA) showed the actual needs of this strategy when the possibility threshold was 0.01 for the primary cohort, and at thresholds of 0.02–0.83 and 0.01–0.88 for the two sub-cohorts, respectively. In addition, this strategy exhibited a significant prognostic capacity compared to the traditional single predictors, and this optimization was also observed in two external validation cohorts. Conclusions: We developed and validated an admission warning strategy that can be quickly deployed in the emergency department. This strategy can be used as an ideal tool for predicting hospital discharge outcomes and providing objective evidence for early informed consent of the hospital discharge outcome to the family members of TBI patients.
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spelling pubmed-88806922022-02-26 Chinese Admission Warning Strategy for Predicting the Hospital Discharge Outcome in Patients with Traumatic Brain Injury Zheng, Ruizhe Zhuang, Zhongwei Zhao, Changyi Zhao, Zhijie Yang, Xitao Zhou, Yue Pan, Shuming Chen, Kui Li, Keqin Huang, Qiong Wang, Yang Ma, Yanbin J Clin Med Article Objective: To develop and validate an admission warning strategy that incorporates the general emergency department indicators for predicting the hospital discharge outcome of patients with traumatic brain injury (TBI) in China. Methods: This admission warning strategy was developed in a primary cohort that consisted of 605 patients with TBI who were admitted within 6 h of injury. The least absolute shrinkage and selection operator and multivariable logistic regression analysis were used to develop the early warning strategy of selected indicators. Two sub-cohorts consisting of 180 and 107 patients with TBI were used for the external validation. Results: Indicators of the strategy included three categories: baseline characteristics, imaging and laboratory indicators. This strategy displayed good calibration and good discrimination. A high C-index was reached in the internal validation. The multicenter external validation cohort still showed good discrimination C-indices. Decision curve analysis (DCA) showed the actual needs of this strategy when the possibility threshold was 0.01 for the primary cohort, and at thresholds of 0.02–0.83 and 0.01–0.88 for the two sub-cohorts, respectively. In addition, this strategy exhibited a significant prognostic capacity compared to the traditional single predictors, and this optimization was also observed in two external validation cohorts. Conclusions: We developed and validated an admission warning strategy that can be quickly deployed in the emergency department. This strategy can be used as an ideal tool for predicting hospital discharge outcomes and providing objective evidence for early informed consent of the hospital discharge outcome to the family members of TBI patients. MDPI 2022-02-13 /pmc/articles/PMC8880692/ /pubmed/35207247 http://dx.doi.org/10.3390/jcm11040974 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Zheng, Ruizhe
Zhuang, Zhongwei
Zhao, Changyi
Zhao, Zhijie
Yang, Xitao
Zhou, Yue
Pan, Shuming
Chen, Kui
Li, Keqin
Huang, Qiong
Wang, Yang
Ma, Yanbin
Chinese Admission Warning Strategy for Predicting the Hospital Discharge Outcome in Patients with Traumatic Brain Injury
title Chinese Admission Warning Strategy for Predicting the Hospital Discharge Outcome in Patients with Traumatic Brain Injury
title_full Chinese Admission Warning Strategy for Predicting the Hospital Discharge Outcome in Patients with Traumatic Brain Injury
title_fullStr Chinese Admission Warning Strategy for Predicting the Hospital Discharge Outcome in Patients with Traumatic Brain Injury
title_full_unstemmed Chinese Admission Warning Strategy for Predicting the Hospital Discharge Outcome in Patients with Traumatic Brain Injury
title_short Chinese Admission Warning Strategy for Predicting the Hospital Discharge Outcome in Patients with Traumatic Brain Injury
title_sort chinese admission warning strategy for predicting the hospital discharge outcome in patients with traumatic brain injury
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8880692/
https://www.ncbi.nlm.nih.gov/pubmed/35207247
http://dx.doi.org/10.3390/jcm11040974
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