Prediction of motor status 3 and 6 months post severe traumatic brain injury: a preliminary study.
The prediction of outcome following severe traumatic brain injury has received considerable attention in recent years. Previous prediction studies have focused on a long-term follow-up or prediction period. The reported outcome measures generally adopted a global approach (e.g. independent living) in terms of the prediction of physical function. The objective of the present study was to construct clinically useful predictive equations of motor system status, as represented by selected postural reactions (indicators of central nervous system function). Specifically, these equations would serve to predict the recovery of equilibrium and protective reactions both at 3 and 6 months post-injury, respectively. A stepwise multiple logistic regression analysis was performed, where nine predictive variables were considered using a multivariate approach. The results indicate that coma duration followed by age contribute significantly to the predictive capability of the models at both 3 and 6 months post-injury. Specifically, at 3 months, the predictive variables 'coma duration' and 'age' enabled an 84.62% correct prediction rate, whereas, at 6 months, 'coma duration' and 'age' enabled a 79.49% correct prediction rate. In addition, the exact probabilities (for given sample ages and coma durations) and associated 95% confidence intervals were calculated based on the predictive models obtained. The theoretical framework underlying these predictive models can form the basis for further studies. Furthermore, these preliminary predictive models have potential implications for early treatment planning and patient management.
Macpherson
V
V
Ecole de réadaptation, Faculté de médecine, Université de Montréal, Québec, Canada.
Sullivan
S J
SJ
Lambert
J
J
D000328:Adult; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D015600:Glasgow Coma Scale; D016489:Head Injuries, Closed / Q000503:physiopathology / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D009460:Neurologic Examination / Q000706:statistics & numerical data*; D004856:Postural Balance / Q000502:physiology; D011596:Psychomotor Disorders / Q000503:physiopathology / Q000534:rehabilitation*; D012018:Reflex / Q000502:physiology; D012044:Regression Analysis