title: Predicting outcome in severe traumatic brain injury using a simple prognostic model.
abstract: BACKGROUND
  Several studies have made it possible to predict outcome in severe traumatic brain injury (TBI) making it beneficial as an aid for clinical decision-making in the emergency setting. However, reliable predictive models are lacking for resource-limited prehospital settings such as those in developing countries like South Africa.
  
  
  OBJECTIVE
  To develop a simple predictive model for severe TBI using clinical variables in a South African prehospital setting.
  
  
  METHODS
  All consecutive patients admitted at two level-one centres in Cape Town, South Africa, for severe TBI were included. A binary logistic regression model was used, which included three predictor variables: oxygen saturation (SpO₂), Glasgow Coma Scale (GCS) and pupil reactivity. The Glasgow Outcome Scale was used to assess outcome on hospital discharge.
  
  
  RESULTS
  A total of 74.4% of the outcomes were correctly predicted by the logistic regression model. The model demonstrated SpO₂ (p=0.019), GCS (p=0.001) and pupil reactivity (p=0.002) as independently significant predictors of outcome in severe TBI. Odds ratios of a good outcome were 3.148 (SpO₂ ≥ 90%), 5.108 (GCS 6 - 8) and 4.405 (pupils bilaterally reactive).
  
  
  CONCLUSIONS
  This model is potentially useful for effective predictions of outcome in severe TBI.
authors.affiliation: Department of Emergency Medical Sciences, Faculty of Health and Wellness Sciences, Cape Peninsula University of Technology, Cape Town, South Africa. simpiwesobuwa@gmail.com.
authors.forename: Simpiwe
authors.initials: S
authors.lastname: Sobuwa
authors.forename: Henry Benjamin
authors.initials: HB
authors.lastname: Hartzenberg
authors.forename: Heike
authors.initials: H
authors.lastname: Geduld
authors.forename: Corrie
authors.initials: C
authors.lastname: Uys
mesh_terms: D000293:Adolescent; D000328:Adult; D001930:Brain Injuries / Q000175:diagnosis* / Q000453:epidemiology; D003661:Decision Support Techniques; D004632:Emergency Medical Services / Q000379:methods; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods / Q000592:standards; D010101:Oxygen Consumption; D011379:Prognosis; D012025:Reflex, Pupillary; D015203:Reproducibility of Results; D013019:South Africa / Q000453:epidemiology