title: Predicting long-term outcome after traumatic brain injury using repeated measurements of Glasgow Coma Scale and data mining methods.
abstract: Previous studies have identified some clinical parameters for predicting long-term functional recovery and mortality after traumatic brain injury (TBI). Here, data mining methods were combined with serial Glasgow Coma Scale (GCS) scores and clinical and laboratory parameters to predict 6-month functional outcome and mortality in patients with TBI. Data of consecutive adult patients presenting at a trauma center with moderate-to-severe head injury were retrospectively analyzed. Clinical parameters including serial GCS measurements at emergency department, 7th day, and 14th day and laboratory data were included for analysis (n = 115). We employed artificial neural network (ANN), naïve Bayes (NB), decision tree, and logistic regression to predict mortality and functional outcomes at 6 months after TBI. Favorable functional outcome was achieved by 34.8% of the patients, and overall 6-month mortality was 25.2%. For 6-month functional outcome prediction, ANN was the best model, with an area under the receiver operating characteristic curve (AUC) of 96.13%, sensitivity of 83.50%, and specificity of 89.73%. The best predictive model for mortality was NB with AUC of 91.14%, sensitivity of 81.17%, and specificity of 90.65%. Sensitivity analysis demonstrated GCS measurements on the 7th and 14th day and difference between emergency room and 14th day GCS score as the most influential attributes both in mortality and functional outcome prediction models. Analysis of serial GCS measurements using data mining methods provided additional predictive information in relation to 6-month mortality and functional outcome in patients with moderate-to-severe TBI.
authors: Department of Industrial Engineering and Management, National Yunlin University of Science and Technology, Douliou City, Yun-Lin county, 640, Taiwan, hylu@yuntech.edu.tw.
authors: Hsueh-Yi
authors: HY
authors: Lu
authors: Tzu-Chi
authors: TC
authors: Li
authors: Yong-Kwang
authors: YK
authors: Tu
authors: Jui-Chang
authors: JC
authors: Tsai
authors: Hong-Shiee
authors: HS
authors: Lai
authors: Lu-Ting
authors: LT
authors: Kuo
mesh_terms: D000328:Adult; D000368:Aged; D001499:Bayes Theorem; D001930:Brain Injuries / Q000175:diagnosis* / Q000401:mortality / Q000503:physiopathology*; D057225:Data Mining / Q000379:methods*; D003663:Decision Trees; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D008297:Male; D008875:Middle Aged; D016571:Neural Networks, Computer; D011379:Prognosis; D012372:ROC Curve; D020127:Recovery of Function; D012189:Retrospective Studies; D014193:Trauma Centers
references: Lancet. 1973 Sep 22;2(7830):631-5
references: 4125617
references: J Neurosurg. 1977 Oct;47(4):491-502
references: 903803
references: Stat Med. 2000 Jan 15;19(1):113-32
references: 10623917
references: Cortex. 1994 Sep;30(3):527-32
references: 7528650
references: Sensors (Basel). 2010;10 (12 ):10733-51
references: 22163496
references: PLoS Med. 2008 Aug 5;5(8):e165; discussion e165
references: 18684008
references: J Med Syst. 2014 Aug;38(8):60
references: 24957386
references: J Neurotrauma. 2007 Feb;24(2):270-80
references: 17375991
references: J Neurosurg. 1968 Sep;29(3):242-51
references: 5684406
references: J Neurotrauma. 2012 Nov 20;29(17):2613-24
references: 22994879
references: Neurosurgery. 2005 Dec;57(6):1173-82; discussion 1173-82
references: 16331165
references: Crit Care Med. 2013 Apr;41(4):1104-23
references: 23528755
references: J Neurotrauma. 2012 May 1;29(7):1306-12
references: 22150207
references: JACEP. 1979 Feb;8(2):64-7
references: 439545
references: BMJ. 1994 Jul 16;309(6948):188
references: 8044101
references: BMJ. 2008 Feb 23;336(7641):425-9
references: 18270239
references: Br J Surg. 2012 Jan;99 Suppl 1:122-30
references: 22441866
references: Neurosurgery. 1980 Mar;6(3):237-42
references: 7383286
references: Lancet Neurol. 2008 Aug;7(8):728-41
references: 18635021
references: BMC Med Inform Decis Mak. 2005 Feb 15;5:3
references: 15713231
references: J Neurol Neurosurg Psychiatry. 1981 Apr;44(4):285-93
references: 6453957
references: BMJ. 2004 Jul 17;329(7458):168-9
references: 15258077
references: J Trauma. 1997 Jan;42(1):7-10
references: 9003251
references: Injury. 2010 Aug;41(8):869-73
references: 20494353
references: J Neurosurg. 1981 Jun;54(6):751-62
references: 7241184
references: J Clin Neurol. 2012 Sep;8(3):224-9
references: 23091533
references: Lancet Neurol. 2010 Apr;9(4):331
references: 20298955
references: Arch Surg. 2002 Mar;137(3):285-90
references: 11888450
references: Ann R Coll Surg Engl. 2004 Sep;86(5):334-8
references: 15333167
references: Eur J Epidemiol. 1994 Feb;10(1):29-36
references: 7957786
references: J Neurosurg. 1982 Dec;57(6):779-83
references: 7143060
references: J Biomed Inform. 2002 Oct-Dec;35(5-6):352-9
references: 12968784
references: J Neurotrauma. 2013 Jan 1;30(1):17-22
references: 22931390
references: J Neurotrauma. 2004 Jul;21(7):886-93
references: 15307901
references: Lancet. 2000 Sep 9;356(9233):923-9
references: 11036909
references: J Emerg Med. 2009 Nov;37(4):451-5
references: 19272743
references: Psychol Bull. 1979 Mar;86(2):420-8
references: 18839484
references: J Neurotrauma. 2005 Oct;22(10):1040-51
references: 16238482
references: Int J Med Inform. 2008 Feb;77(2):81-97
references: 17188928
references: Lancet Neurol. 2010 May;9(5):543-54
references: 20398861
references: J Neurol Neurosurg Psychiatry. 1999 Jan;66(1):20-5
references: 9886445
references: Acta Paediatr. 2007 Apr;96(4):487-91
references: 17306009
references: J Med Syst. 2014 Mar;38(3):18
references: 24609509
references: J Med Syst. 2014 Sep;38(9):94
references: 25012477
references: Crit Care Med. 2012 May;40(5):1609-17
references: 22511138
references: Lancet. 1974 Jul 13;2(7872):81-4
references: 4136544
references: Acta Paediatr. 2007 Mar;96(3):338-41
references: 17407452
references: J Med Syst. 2002 Oct;26(5):445-63
references: 12182209
references: BMJ. 2005 May 7;330(7499):1080-3
references: 15879401
references: Injury. 2008 May;39(5):598-603
references: 17884053
references: J Neurol Neurosurg Psychiatry. 1977 Mar;40(3):291-8
references: 886355
references: Anesthesiology. 2012 Dec;117(6):1300-10
references: 23135261
references: Eur J Trauma Emerg Surg. 2013 Jun;39(3):285-92
references: 23762202
references: J Head Trauma Rehabil. 2006 Jul-Aug;21(4):298-314
references: 16915007
references: Crit Care Med. 1985 Oct;13(10):818-29
references: 3928249