Severe head injuries: an outcome prediction and survival analysis.

OBJECTIVE

To identify the predictors determined early after admission and associated with unfavorable outcome or early (within 48 h) death after severe head injury.

METHODS

Prospective cohort study.

METHODS

A neurosurgical intensive care unit in a university hospital.

METHODS

198 consecutive comatose patients hospitalized from 1989 to 1992.

RESULTS

Logistic regression showed that a combination of age, best motor response score from the Glasgow Coma Scale, and hypoxia provided a good prediction model of unfavorable outcome (sensitivity = 0.93). The length of participation of survivors was 6 to 61 months (median 27.1). The Cox model demonstrated age, motor score less than 3, mydriasis, and hypoxia as poor prognosis factors.

CONCLUSIONS

Clinicians can determine the odds of a good outcome from the combination of three easily measurable factors using a simple diagram constructed from logistic regression. Survival analysis showed that motor score adjusted values greater than 3 had the same prognosis.