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J Neurol Surg A Cent Eur Neurosurg 2019; 80(06): 423-429
DOI: 10.1055/s-0039-1685137
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Early Prognostication after Traumatic Brain Injury: Specific Validation of the IMPACT Prognostic Calculator in a Level 1 Trauma Center

Anna Jung
1   Department of Neurosurgery, University Hospital Leipzig, Leipzig, Germany
,
Felix Arlt
1   Department of Neurosurgery, University Hospital Leipzig, Leipzig, Germany
,
Maciej Rosolowski
2   Institute for Medical Informatics, Statistics and Epidemiology (IMISE), Medical Faculty, University Leipzig, Leipzig, Germany
,
Jürgen Meixensberger
1   Department of Neurosurgery, University Hospital Leipzig, Leipzig, Germany
› Author Affiliations
Further Information

Publication History

05 February 2018

31 July 2018

Publication Date:
20 August 2019 (online)

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Abstract

The present study evaluated the usefulness of the IMPACT prognostic calculator (IPC) for patients receiving acute neurointensive care at a level 1 trauma center in Germany. A total of 139 patients with traumatic brain injury (TBI) were assessed. One day after trauma, the extended model of the IPC was found to provide the most valid prediction of 6-month mortality/unfavorable outcome. Different time frames within the first day could be determined by analyzing mild, moderate, and severe TBI cohorts. The CORE + CT model at time frame Z2 (<6 h from the point of first documentation) for mild TBI exhibited the highest values in the receiver operating characteristic (ROC) analysis (area under the curve [AUC], 0.9; sensitivity, 1; specificity, 0.7). For patients with moderate head injury at time frame Z2/3 (<6–12 h from point of first documentation), the extended model fit best. For patients with severe TBI, the extended model at time frame Z6 (48–72 h from point of first documentation) best predicted 6-month mortality and unfavorable outcome (ROC analysis: AUC, 0.542/0.445; sensitivity, 0.167/0.364; specificity, 0.575/0.444). Center-specific validation demonstrated the validity of the IPC in the early phase after TBI. These findings support the usefulness of the IPC for predicting the prognosis of patients with TBI. However, further prospective validation using a larger TBI cohort is needed.

Keywords

prognostication - traumatic brain injury - impact prognosis calculator
 

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