Predictors of outcome in head injury: proposal of a new scaling system

Abstract

Background: In a statistical outcome analysis covering 10 years, 554 patients with isolated head trauma were analyzed. The aim of this study was to combine clinical and computed tomographic characteristics in a prognostic scoring system determining outcome after head injury.

Methods: After collection of data, mortality and morbidity were determined for each clinical and radiologic parameter; a different grading from 1 to 8 points was then attached to each parameter. The total score for each patient was calculated by adding the individual points from the different parameters.

Results: Significant differences in outcome (p < 0.01, Mann-Whitney U test) were registered in steps from 0 to 10 points (group I), 11 to 20 points (group II), and > 20 points (group III). Group I had a mortality of 8.3%, and patients in groups II and III died in 51.2% and 80.8%, respectively. Patients in group I had a Glasgow Outcome Scale (GOS) score of 4 and 5 in 19.4% and 56.7%, respectively, whereas group II reached a GOS score of 4 or 5 in only 9.9% and 1.7%, respectively. Patients in group III never reached a GOS score of 4 or 5.

Conclusion: The presented scaling system allows a predictive value in mortality and morbidity to be determined for each patient suffering from brain trauma.