Development and Validation of a Nomogram for Predicting the Mortality after Penetrating Traumatic Brain Injury

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Tunthanathip Thara; Udomwitthayaphiban Suphak

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Journal: Bulletin of Emergency And Trauma Year:2019 | Volume:7 | Issue:4 Page(s): 347-354

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Title

Development and Validation of a Nomogram for Predicting the Mortality after Penetrating Traumatic Brain Injury

Author(s)

Tunthanathip Thara | Udomwitthayaphiban Suphak | Issue Writer Certificate

Keywords

Penetrating brain injury

Traumatic brain injury (TBI)

Nomogram

Abstract

Objective: To determine the factors associated with mortality in Penetrating brain injury (PTBI) and proposed the Nomogram predicting the risk of death. Methods: A retrospective cohort study was conducted on all patients who had sustained PTBI between 2009 and 2018. Collected data included clinical characteristics, neuroimaging findings, treatment, and outcomes. Prognostic factors analysis was conducted using a forest plot. Therefore, the Nomogram was developed and validated. For the propose of evaluation, the Nomogram’ s sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), Receiver Operating Characteristic (ROC) curve and the area under the receiver operating characteristic (AUC) were determined for validating the optimal cut-off point of the total scores. Results: During the study period, 62 individuals enrolled. In the univariate analysis, factors associated with the morality were normal pupils’ reactivity to light (OR 0. 04, p<0. 001), hypotension (OR 9. 91, p<0. 001), hypoxia (OR 10. 2, p=0. 04), bihemispheric injuries (OR 19. 0, p=0. 001), multilobar injuries (OR 21. 5, p< 0. 001), subarachnoid hemorrhage (OR 6. 9, p=0. 02), intraventricular hemorrhage (OR 26. 6, p=0. 006), basal cistern effacement (OR 28. 8, , p<0. 001), midline shift >5 mm (OR 0. 19, p<0. 001) were significantly associated with death. In multivariable analysis, hypotension (OR 8. 82, p=0. 03), normal pupils’ reactivity to light (OR 0. 07, p=0. 01), midline shift >5 mm (OR 18. 23, p<0. 007) were significantly associated with death. The Nomogram’ s sensitivity, specificity, PPV, NPV, and AUC for predicting mortality (total score ≥ 100) were 80%, 92. 6%, 72. 7%, 95. 0%, and, 0. 86 respectively. Conclusion: PTBI is the fatal injury depend on both clinical and neuroimaging parameters. The Nomogram is the alternative method providing prognostic parameters toward implication for clinical decision making.

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APA: Copy

Tunthanathip, Thara, & Udomwitthayaphiban, Suphak. (2019). Development and Validation of a Nomogram for Predicting the Mortality after Penetrating Traumatic Brain Injury. BULLETIN OF EMERGENCY AND TRAUMA BEAT, 7(4), 347-354. SID. https://sid.ir/paper/335195/en

Vancouver: Copy

Tunthanathip Thara, Udomwitthayaphiban Suphak. Development and Validation of a Nomogram for Predicting the Mortality after Penetrating Traumatic Brain Injury. BULLETIN OF EMERGENCY AND TRAUMA BEAT[Internet]. 2019;7(4):347-354. Available from: https://sid.ir/paper/335195/en

IEEE: Copy

Thara Tunthanathip, and Suphak Udomwitthayaphiban, “Development and Validation of a Nomogram for Predicting the Mortality after Penetrating Traumatic Brain Injury,” BULLETIN OF EMERGENCY AND TRAUMA BEAT, vol. 7, no. 4, pp. 347–354, 2019, [Online]. Available: https://sid.ir/paper/335195/en

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