E-ISSN: 1019-5157
ISSN: 2651-5024
Research
Surgical Treatment Outcome Prediction Score for Traumatic Brain Injury
Shun Yamamuro✉ ,
Masato Kobayashi ,
Takeshi Maeda ,
Atsuo Yoshino
Department of Neurological Surgery, Nihon University School of Medicine
Article in Press
Corresponding Author:
Shun Yamamuro (yamamuro.shun@nihon-u.ac.jp)
Abstract
Aim
The postoperative prognosis after decompression surgery for traumatic brain injury (TBI) remains poor, with some patients left in a vegetative state or dying postoperatively. This study aimed to develop a simple preoperative scoring system to predict poor postoperative outcomes and improve clinical decision-making.
Material and Methods
This study retrospectively analyzed 133 patients who underwent decompression craniectomy for TBI at our institution from January 2014 to December 2024. Poor outcome was defined as a Glasgow Outcome Scale score 1 or 2. Preoperative clinical and radiological factors were compared between the poor and not-poor outcome groups. Significant variables were binarized and a weighted scoring system was developed using multivariate logistic regression.
Results
Four factors were identified as independent predictors of poor outcome: age ≥80 years, Glasgow Coma Scale (GCS) score ≤5, midline shift ≥12 mm, and presence of contralateral lesions (cerebral contusion or acute subdural hematoma). GCS score ≤5 and midline shift ≥12 mm were assigned 2 points and the other factors 1 point each, resulting in a weighted scoring system score ranging from 0 to 7. The incidence of poor outcomes was 6.1% in the 0-point group, 50.1% in the 13-point group, and 95.2% in the 47-point group, showing a strong correlation with the score strata.
Conclusion
This score is a simple and practical tool for predicting poor postoperative outcomes using preoperative data, and may be useful in early surgical decision-making support communication with families, and promote the most appropriate care.
The postoperative prognosis after decompression surgery for traumatic brain injury (TBI) remains poor, with some patients left in a vegetative state or dying postoperatively. This study aimed to develop a simple preoperative scoring system to predict poor postoperative outcomes and improve clinical decision-making.
Material and Methods
This study retrospectively analyzed 133 patients who underwent decompression craniectomy for TBI at our institution from January 2014 to December 2024. Poor outcome was defined as a Glasgow Outcome Scale score 1 or 2. Preoperative clinical and radiological factors were compared between the poor and not-poor outcome groups. Significant variables were binarized and a weighted scoring system was developed using multivariate logistic regression.
Results
Four factors were identified as independent predictors of poor outcome: age ≥80 years, Glasgow Coma Scale (GCS) score ≤5, midline shift ≥12 mm, and presence of contralateral lesions (cerebral contusion or acute subdural hematoma). GCS score ≤5 and midline shift ≥12 mm were assigned 2 points and the other factors 1 point each, resulting in a weighted scoring system score ranging from 0 to 7. The incidence of poor outcomes was 6.1% in the 0-point group, 50.1% in the 13-point group, and 95.2% in the 47-point group, showing a strong correlation with the score strata.
Conclusion
This score is a simple and practical tool for predicting poor postoperative outcomes using preoperative data, and may be useful in early surgical decision-making support communication with families, and promote the most appropriate care.
Keywords
traumatic brain injury
postoperative outcome
acute epidural hematoma
acute subdural hematoma
cerebral contusion