Prediction of Global Functional Outcome and Post-Concussive Symptoms after Mild Traumatic Brain Injury: External Validation of Prognostic Models in the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) Study

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Prediction of Global Functional Outcome and Post-Concussive Symptoms after Mild Traumatic Brain Injury : External Validation of Prognostic Models in the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) Study

Mikolić, Ana (författare): Department of Public Health, Center for Medical Decision Making, Erasmus MC-University Medical Center Rotterdam, The Netherlands

Polinder, Suzanne (författare): Department of Public Health, Center for Medical Decision Making, Erasmus MC-University Medical Center Rotterdam, The Netherlands

Steyerberg, Ewout W. (författare): Department of Public Health, Center for Medical Decision Making, Erasmus MC-University Medical Center Rotterdam, The Netherlands; Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, The Netherlands

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Retel Helmrich, Isabel R. A. (författare): Department of Public Health, Center for Medical Decision Making, Erasmus MC-University Medical Center Rotterdam, The Netherlands

Giacino, Joseph T. (författare): Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, Massachusetts, USA; Department of Physical Medicine and Rehabilitation, Harvard Medical School, Cambridge, Massachusetts, USA

Maas, Andrew I. R. (författare): Department of Neurosurgery, Antwerp University Hospital and University of Antwerp, Antwerp, Belgium

van der Naalt, Joukje (författare): Department of Neurology, University of Groningen, University Medical Center Groningen, The Netherlands

Voormolen, Daphne C. (författare): Department of Public Health, Center for Medical Decision Making, Erasmus MC-University Medical Center Rotterdam, The Netherlands

von Steinbüchel, Nicole (författare): Institute of Medical Psychology and Medical Sociology, Georg-August-University, Göttingen, Germany

Wilson, Lindsay (författare): Division of Psychology, University of Stirling, Stirling, United Kingdom

Lingsma, Hester F. (författare): Department of Public Health, Center for Medical Decision Making, Erasmus MC-University Medical Center Rotterdam, The Netherlands

van Klaveren, David (författare): Department of Public Health, Center for Medical Decision Making, Erasmus MC-University Medical Center Rotterdam, The Netherlands; Predictive Analytics and Comparative Effectiveness Center, Institute for Clinical Research and Health Policy Studies/Tufts Medical Center, Boston, Massachusetts, USA

Brorsson, Camilla (författare): Umeå universitet,Institutionen för kirurgisk och perioperativ vetenskap

Oresic, Matej, 1967- (bidragsgivare): Örebro universitet,Institutionen för medicinska vetenskaper

Koskinen, Lars-Owe, Professor, 1955- (bidragsgivare): Umeå universitet,Neurovetenskaper

Sundström, Nina (bidragsgivare): Umeå universitet,Institutionen för strålningsvetenskaper

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2020-10-19
2021
Engelska.
Ingår i: Journal of Neurotrauma. - : Mary Ann Liebert. - 0897-7151 .- 1557-9042. ; 38:2, s. 196-209

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The majority of traumatic brain injuries (TBIs) are categorized as mild, according to a baseline Glasgow Coma Scale (GCS) score of 13-15. Prognostic models that were developed to predict functional outcome and persistent post-concussive symptoms (PPCS) after mild TBI have rarely been externally validated. We aimed to externally validate models predicting 3-12-month Glasgow Outcome Scale Extended (GOSE) or PPCS in adults with mild TBI. We analyzed data from the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) project, which included 2862 adults with mild TBI, with 6-month GOSE available for 2374 and Rivermead Post-Concussion Symptoms Questionnaire (RPQ) results available for 1605 participants. Model performance was evaluated based on calibration (graphically and characterized by slope and intercept) and discrimination (C-index). We validated five published models for 6-month GOSE and three for 6-month PPCS scores. The models used different cutoffs for outcome and some included symptoms measured 2 weeks post-injury. Discriminative ability varied substantially (C-index between 0.58 and 0.79). The models developed in the Corticosteroid Randomisation After Significant Head Injury (CRASH) trial for prediction of GOSE <5 discriminated best (C-index 0.78 and 0.79), but were poorly calibrated. The best performing models for PPCS included 2-week symptoms (C-index 0.75 and 0.76). In conclusion, none of the prognostic models for early prediction of GOSE and PPCS has both good calibration and discrimination in persons with mild TBI. In future studies, prognostic models should be tailored to the population with mild TBI, predicting relevant end-points based on readily available predictors.

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Av författaren/redakt...: Mikolić, Ana; Polinder, Suzann ...; Steyerberg, Ewou ...; Retel Helmrich, ...; Giacino, Joseph ...; Maas, Andrew I. ...; visa fler...; van der Naalt, J ...; Voormolen, Daphn ...; von Steinbüchel, ...; Wilson, Lindsay; Lingsma, Hester ...; van Klaveren, Da ...; Brorsson, Camill ...; Oresic, Matej, 1 ...; Koskinen, Lars-O ...; Sundström, Nina; visa färre...

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MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Neurologi

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Av lärosätet: Örebro universitet; Umeå universitet; Karolinska Institutet

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Prediction of Global Functional Outcome and Post-Concussive Symptoms after Mild Traumatic Brain Injury : External Validation of Prognostic Models in the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) Study

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