title: Predicting the outcome for individual patients with traumatic brain injury: a case-based review.
abstract: BACKGROUND
  Traumatic brain injuries result in significant morbidity and mortality. Accurate prediction of prognosis is desirable to inform treatment decisions and counsel family members. Objective To review the currently available prognostic tools for use in traumatic brain injury (TBI), to analyse their value in individual patient management and to appraise ongoing research on prognostic modelling.
  
  
  RESULTS
  We present two patients who sustained a TBI in 2011-2012 and evaluate whether prognostic models could accurately predict their outcome. The methodology and validity of current prognostic models are analysed and current research that might contribute to improved individual patient prognostication is evaluated.
  
  
  CONCLUSIONS
  Predicting prognosis in the acute phase after TBI is complex and existing prognostic models are not suitable for use at the individual patient level. Data derived from these models should only be used as an adjunct to clinical judgement and should not be used to set limits for acute care interventions. Information from neuroimaging, physiological monitoring and analysis of biomarkers or genetic polymorphisms may be used in the future to improve accuracy of individual patient prognostication. Clinicians should consider offering full supportive treatment to patients in the early phase after injury whilst the outcome is unclear.
authors: a Division of Anaesthesia and Intensive Care Medicine, Department of Medicine , Addenbrooke's Hospital & University of Cambridge , Cambridge , UK ;|b Department of Anaesthesia , National Hospital for Neurology and Neurosurgery , London , UK ;
authors: Eleanor L
authors: EL
authors: Carter
authors: c Division of Neurosurgery, Department of Clinical Neurosciences , Addenbrooke's Hospital & University of Cambridge , Cambridge , UK.
authors: Peter J A
authors: PJ
authors: Hutchinson
authors: c Division of Neurosurgery, Department of Clinical Neurosciences , Addenbrooke's Hospital & University of Cambridge , Cambridge , UK.
authors: Angelos G
authors: AG
authors: Kolias
authors: a Division of Anaesthesia and Intensive Care Medicine, Department of Medicine , Addenbrooke's Hospital & University of Cambridge , Cambridge , UK ;
authors: David K
authors: DK
authors: Menon
mesh_terms: D000328:Adult; D000070642:Brain Injuries, Traumatic / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery*; D003422:Critical Care; D005260:Female; D023261:Glasgow Outcome Scale; D006801:Humans; D008297:Male; D008991:Monitoring, Physiologic; D059906:Neuroimaging; D011379:Prognosis; D055815:Young Adult
keywords: Head injury; TBI; neurosurgical intensive care; outcome; prognosis