Predictive utility of an adapted Marshall head CT classification scheme after traumatic brain injury

被引：23

作者：

Brown, Allen W. ^{[1
]}

Pretz, Christopher R. ^{[2
]}

Bell, Kathleen R. ^{[3
]}

Hammond, Flora M. ^{[4
]}

Arciniegas, David B. ^{[5
,6
,7
,8
]}

Bodien, Yelena G. ^{[9
,10
]}

Dams-O'Connor, Kristen ^{[11
,12
]}

Giacino, Joseph T. ^{[10
]}

Hart, Tessa ^{[13
]}

Johnson-Greene, Douglas ^{[14
]}

Kowalski, Robert G. ^{[15
]}

Walker, William C. ^{[16
]}

Weintraub, Alan ^{[17
]}

Zafonte, Ross ^{[10
,18
]}

机构：

[1] Mayo Clin, Dept Phys Med & Rehabil, 200 First St SW, Rochester, MN 55905 USA

[2] Craig Hosp, Traumat Brain Injury Model Syst Natl Data & Stat, Englewood, CO USA

[3] Univ Texas Southwestern, Dept Phys Med & Rehabil, Dallas, TX USA

[4] Indiana Univ Sch Med, Dept Phys Med & Rehabil, Rehabil Hosp Indiana, Indianapolis, IN 46202 USA

[5] Ctr Mental Hlth, Gunnison, CO USA

[6] Univ Colorado, Sch Med, Dept Neurol, Aurora, CO USA

[7] Univ Colorado, Sch Med, Dept Psychiat, Aurora, CO USA

[8] TIRR Mem Hermann, Brain Injury Res Ctr, Houston, TX USA

[9] Harvard Med Sch, Dept Neurol, Massachusetts Gen Hosp, Boston, MA 02115 USA

[10] Spaulding Rehabil Hosp, Dept Phys Med & Rehabil, Charlestown, MA USA

[11] Icahn Sch Med Mt Sinai, Dept Rehabil Med, New York, NY 10029 USA

[12] Icahn Sch Med Mt Sinai, Dept Neurol, New York, NY 10029 USA

[13] Moss Rehabil Res Inst, Elkins Pk, PA USA

[14] Univ Miami, Miller Sch Med, Dept Phys Med & Rehabil, Miami, FL 33136 USA

[15] Craig Hosp, Res Dept, Englewood, CO USA

[16] Virginia Commonwealth Univ, Dept Phys Med & Rehabil, Richmond, VA USA

[17] Craig Hosp, Craig Hosp Rocky Mt Reg Brain Injury Syst, Englewood, CO USA

[18] Harvard Med Sch, Brigham & Womens Hosp, Massachusetts Gen Hosp, Dept Phys Med & Rehabil, Boston, MA 02115 USA

来源：

BRAIN INJURY | 2019年 / 33卷 / 05期

关键词：

Clinical decision-making; computed tomography; craniocerebral trauma; forecasting; neuroimaging; GLASGOW OUTCOME SCALE;

D O I：

10.1080/02699052.2019.1566970

中图分类号：

Q189 [神经科学];

学科分类号：

071006 ;

摘要：

Objective: To study the predictive relationship among persons with traumatic brain injury (TBI) between an objective indicator of injury severity (the adapted Marshall computed tomography [CT] classification scheme) and clinical indicators of injury severity in the acute phase, functional outcomes at inpatient rehabilitation discharge, and functional and participation outcomes at 1 year after injury, including death. Participants: The sample involved 4895 individuals who received inpatient rehabilitation following acute hospitalization for TBI and were enrolled in the Traumatic Brain Injury Model Systems National Database between 1989 and 2014. Design: Head CT variables for each person were fit into adapted Marshall CT classification categories I through IV. Main Measures: Prediction models were developed to determine the amount of variability explained by the CT classification categories compared with commonly used predictors, including a clinical indicator of injury severity. Results: The adapted Marshall classification categories aided only in the prediction of craniotomy or craniectomy during acute hospitalization, otherwise making no meaningful contribution to variance in the multivariable models predicting outcomes at any time point after injury. Conclusion: Results suggest that head CT findings classified in this manner do not inform clinical discussions related to functional prognosis or rehabilitation planning after TBI.

引用

页码：610 / 617

页数：8

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