Derivation of a bioclinical prognostic index in severe head injury.
We investigated the problem of outcome prediction from seven risk factors in 40 severely head injured patients - 13 favorable and 27 unfavorable outcomes. By applying stepwise logistic discriminant analysis to the patients' data, we selected three significant risk variables: cerebrospinal fluid (CSF) CK-BB isoenzyme activity recorded on admission, severely raised intracranial pressure (more than 40 mmHg) and age, respectively. CSF CK-BB activity, which quantifies the initial neurological damage, proved to be the best prognostic factor. The presence of severe intracranial hypertension was always associated with a bad outcome, whereas its absence was not necessarily indicative of good prognosis. Finally, we combined the three selected variables into a single risk index, which allowed correct predictions in 92% of patients with favorable outcome and in 85% of patients with unfavorable outcome (total predictive efficiency 88%).
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D006259:Craniocerebral Trauma / Q000175:diagnosis* / Q000401:mortality; D003402:Creatine Kinase / Q000134:cerebrospinal fluid; D005260:Female; D006801:Humans; D007427:Intracranial Pressure; D007527:Isoenzymes; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012306:Risk; D013223:Statistics as Topic
D007527:Isoenzymes; D003402:Creatine Kinase