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  • Nelson, David W.Karolinska Institutet (author)

Multivariate outcome prediction in traumatic brain injury with focus on laboratory values

  • Article/chapterEnglish2012

Publisher, publication year, extent ...

  • Mary Ann Liebert Inc,2012
  • printrdacarrier

Numbers

  • LIBRIS-ID:oai:DiVA.org:ri-51167
  • https://urn.kb.se/resolve?urn=urn:nbn:se:ri:diva-51167URI
  • https://doi.org/10.1089/neu.2012.2468DOI
  • http://kipublications.ki.se/Default.aspx?queryparsed=id:125733372URI

Supplementary language notes

  • Language:English
  • Summary in:English

Part of subdatabase

Classification

  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  • Traumatic brain injury (TBI) is a major cause of morbidity and mortality. Identifying factors relevant to outcome can provide a better understanding of TBI pathophysiology, in addition to aiding prognostication. Many common laboratory variables have been related to outcome but may not be independent predictors in a multivariate setting. In this study, 757 patients were identified in the Karolinska TBI database who had retrievable early laboratory variables. These were analyzed towards a dichotomized Glasgow Outcome Scale (GOS) with logistic regression and relevance vector machines, a non-linear machine learning method, univariately and controlled for the known important predictors in TBI outcome: age, Glasgow Coma Score (GCS), pupil response, and computed tomography (CT) score. Accuracy was assessed with Nagelkerke's pseudo R2. Of the 18 investigated laboratory variables, 15 were found significant (p<0.05) towards outcome in univariate analyses. In contrast, when adjusting for other predictors, few remained significant. Creatinine was found an independent predictor of TBI outcome. Glucose, albumin, and osmolarity levels were also identified as predictors, depending on analysis method. A worse outcome related to increasing osmolarity may warrant further study. Importantly, hemoglobin was not found significant when adjusted for post-resuscitation GCS as opposed to an admission GCS, and timing of GCS can thus have a major impact on conclusions. In total, laboratory variables added an additional 1.3-4.4% to pseudo R2.

Subject headings and genre

  • Glasgow Coma Score
  • Glasgow Outcome Scale
  • hematologic tests
  • outcome
  • traumatic brain injury (TBI)
  • albumin
  • creatinine
  • glucose
  • adolescent
  • article
  • computer assisted tomography
  • female
  • human
  • laboratory test
  • machine learning
  • major clinical study
  • male
  • osmolarity
  • outcome assessment
  • predictor variable
  • pupil reflex
  • traumatic brain injury
  • Adult
  • Age Factors
  • Aged
  • Aged
  • 80 and over
  • Biological Markers
  • Blood Chemical Analysis
  • Brain Injuries
  • Glasgow Coma Scale
  • Humans
  • Linear Models
  • Logistic Models
  • Middle Aged
  • Multivariate Analysis
  • Nonlinear Dynamics
  • Predictive Value of Tests
  • Prognosis
  • Sex Factors
  • Treatment Outcome
  • Young Adult

Added entries (persons, corporate bodies, meetings, titles ...)

  • Rudehill, AndersKarolinska Institute, Sweden (author)
  • MacCallum, Robert M.Imperial College London, UK (author)
  • Holst, AndersRISE,SICS(Swepub:ri)AndersHol@ri.se (author)
  • Wanecek, MichaelKarolinska Institutet (author)
  • Weitzberg, EddieKarolinska Institutet (author)
  • Bellander, Bo MichaelKarolinska Institutet (author)
  • Karolinska InstitutetKarolinska Institute, Sweden (creator_code:org_t)

Related titles

  • In:Journal of Neurotrauma: Mary Ann Liebert Inc29:17, s. 2613-26240897-71511557-9042

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