ArticleNeurotrauma reports
Inpatient Metabolic Panel Trajectories Improve 6-Month Mortality Prognostication after Severe Traumatic Brain Injury.
Article in Neurotrauma reports. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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13 authors.
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Abstract
The International Mission for Prognosis and Analysis of Clinical Trials (IMPACT) in traumatic brain injury (TBI) only includes data from hospital admission as predictors. Including updated physiological data after hospital admission would likely improve prognostic ability above the IMPACT model alone. We sought to evaluate differences in the daily trajectory of clinical metabolic panels (e.g., glucose, sodium, platelets, hemoglobin) for the first 7 days post-severe TBI (sTBI). This is a prospective cohort study of patients with sTBI with Glasgow Coma Scale (GCS) ≤8. Intake GCS was conducted by a neurosurgeon or neurosurgical resident to ensure GCS at presentation was related to the brain injury and not other factors. We compared daily metabolic panel trajectories between survivors to 6 months and nonsurvivors to 6 months using ordinal mixed-effects models. Dichotomizing trajectories as "high" or "low" was set to 4+ of the first 7 days postinjury to represent a majority of the first postinjury week. We then examined the added prognostic value of these trajectories compared with the IMPACT-extended model for 6-month mortality. Included patients (
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