title: IMPACT Score for Traumatic Brain Injury: Validation of the Prognostic Tool in a Spanish Cohort.
abstract: The aim of this work was to validate the IMPACT (International Mission for Prognosis and Analysis of Clinical Trials in TBI) model in a Spanish cohort of patients with moderate-severe TBI (traumatic brain injury).
  
  
  
  Two level I neurotrauma centers.
  
  
  
  Patients admitted to these hospitals between 2011 and 2014 with a diagnosis of TBI and a Glasgow Coma Scale score of 12 or less.
  
  
  
  Prospective observational study.
  
  
  
  We collected prospectively the clinical variables included in the IMPACT models. Outcome evaluation was prospectively done at 6-month follow-up according to the Glasgow Outcome Scale.
  
  
  
  A total of 290 patients were included in the study. Forty-seven patients (16.2%) died within 6 months post-TBI, and 74 patients (25.5%) had an unfavorable outcome. The Hosmer-Lemeshow test revealed that there was no difference between observed and predicted outcomes; hence, the 3 models displayed adequate calibration for predicting 6-month mortality or unfavorable outcome. The receiver operating characteristic curve indicated that the 3 models (Core, Extended, and Lab) could accurately discriminate between favorable and unfavorable outcomes, as well as between survival and mortality (P < .001).
  
  
  
  The IMPACT model validates prediction of 6-month outcomes in a Spanish population of moderate-severe TBI. IMPACT Lab model is the one that presents a higher discriminative capacity. These results encourage the implementation of the IMPACT model as a prognostic tool in the management of patients with TBI.
authors.affiliation: NeuroCritical Care Unit (Drs Egea-Guerrero, Gordillo-Escobar, Fernández-Delgado, Martínez-Roldán, Roldán-Reina, Durán-Martínez, Freire-Aragón, and Murillo-Cabezas) and Emergency Department (Dr Rodríguez-Rodríguez), Virgen del Rocío University Hospital, IBIS/CSIC/University of Seville, Seville, Spain; Internal Medicine, La Princesa University Hospital, Madrid, Spain (Dr de Vega-Ríos); Department of Preventive Medicine and Public Health, Virgen Macarena University Hospital, University of Seville, Seville, Spain (Dr Vilches-Arenas); and Emergency Department, University Hospital La Paz, Madrid, Spain (Dr Quintana-Díaz).
authors.forename: Juan José
authors.initials: JJ
authors.lastname: Egea-Guerrero
authors.forename: Ana
authors.initials: A
authors.lastname: Rodríguez-Rodríguez
authors.forename: Elena
authors.initials: E
authors.lastname: Gordillo-Escobar
authors.forename: Esperanza
authors.initials: E
authors.lastname: Fernández-Delgado
authors.forename: Ángela
authors.initials: Á
authors.lastname: Martínez-Roldán
authors.forename: Álvaro
authors.initials: Á
authors.lastname: Roldán-Reina
authors.forename: Pilar
authors.initials: P
authors.lastname: Durán-Martínez
authors.forename: Enrique
authors.initials: E
authors.lastname: de Vega-Ríos
authors.forename: María Dolores
authors.initials: MD
authors.lastname: Freire-Aragón
authors.forename: Ángel
authors.initials: Á
authors.lastname: Vilches-Arenas
authors.forename: Francisco
authors.initials: F
authors.lastname: Murillo-Cabezas
authors.forename: Manuel
authors.initials: M
authors.lastname: Quintana-Díaz
mesh_terms: D000328:Adult; D000070642:Brain Injuries, Traumatic / Q000175:diagnosis* / Q000401:mortality*; D015331:Cohort Studies; D005260:Female; D015600:Glasgow Coma Scale; D023261:Glasgow Outcome Scale; D006801:Humans; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D017063:Outcome Assessment, Health Care; D011237:Predictive Value of Tests; D011379:Prognosis; D012372:ROC Curve; D013030:Spain; D015996:Survival Rate