title: Predictors of Outcomes in Traumatic Brain Injury.
abstract: BACKGROUND
  The purpose of this study was to retrospectively evaluate patients treated for traumatic brain injuries (TBI) to determine how multiple organ trauma (MOT) and lung injuries sustained at the time of initial injury affect outcome.
  
  
  METHODS
  A single institution retrospective review of all patients diagnosed with TBI at a level I trauma center from 2000 to 2014 was conducted. Clinical outcome was based on Glasgow Outcome Scale at hospital discharge. Lung injury was defined as the presence of pulmonary contusions, pneumothorax, hemothorax, rib fractures, or diaphragmatic rupture proven by x-ray or computed tomography scan. MOT was defined as trauma to one body region with an Abbreviated Injury Scale (AIS) score ≥3 plus trauma to 2 additional body regions with AIS scores ≥1. Regression analysis was conducted with SPSS 21.
  
  
  RESULTS
  There were 409 patients reviewed. The majority of patients were male (73%), average age was 46 years (range, 16-94 years), average Glasgow Coma Scale (GCS) score was 7, and 71% had a severe TBI (GCS ≤8). Thirty percent of patients had poor outcome (Glasgow Outcome Scale = 1-2) Regression analysis indicated age (odds ratio [OR] 1.03, P < 0.001), initial GCS (OR 0.88, P < 0.001), Injury Severity Score (OR 1.03, P = 0.021), and head AIS ≥5 (OR 0.55, P = 0.019) were significant independent predictors of poor outcome. Sex, MOT, lung injury, and lung injury severity were not significant predictors of outcome.
  
  
  CONCLUSIONS
  Age, GCS, Injury Severity Score, and critical head injuries (AIS ≥5) were significant tools in predicting outcome in this patient cohort. MOT and traumatic lung injury may cause significant damage to a patient suffering from a severe TBI, but these injuries do not predict mortality in this patient population.
authors.affiliation: Division of Neurosurgery, University of Toledo Medical Center, Toledo, Ohio, USA.
authors.forename: Justin
authors.initials: J
authors.lastname: Baum
authors.affiliation: Division of Neurosurgery, University of Toledo Medical Center, Toledo, Ohio, USA.
authors.forename: Pouya
authors.initials: P
authors.lastname: Entezami
authors.affiliation: Division of Neurosurgery, University of Toledo Medical Center, Toledo, Ohio, USA.
authors.forename: Kavit
authors.initials: K
authors.lastname: Shah
authors.affiliation: Division of Neurosurgery, University of Toledo Medical Center, Toledo, Ohio, USA. Electronic address: Azedine.Medhkour@utoledo.edu.
authors.forename: Azedine
authors.initials: A
authors.lastname: Medhkour
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000070642:Brain Injuries, Traumatic / Q000175:diagnosis* / Q000401:mortality*; D015897:Comorbidity; D005260:Female; D006801:Humans; D055370:Lung Injury / Q000175:diagnosis / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000175:diagnosis / Q000401:mortality*; D009820:Ohio / Q000453:epidemiology; D011379:Prognosis; D015203:Reproducibility of Results; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods; D012680:Sensitivity and Specificity; D016019:Survival Analysis; D015599:Trauma Severity Indices; D055815:Young Adult
keywords: Outcomes; Traumatic brain injury