Prognostic Models for Global Functional Outcome and Post-Concussion Symptoms Following Mild Traumatic Brain Injury: A Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) Study

• DOI: 10.1089/neu.2022.0320
• Publication Date: 2023-04-20T08:00:42Z
• Authors: Ana Mikolić; Ewout W. Steyerberg; Suzanne Polinder; Lindsay Wilson; Marina Zeldovich; Nicole von Steinb...; Virginia F.J. New...; David K. Menon; Joukje van der Naalt; Hester F. Lingsma; Andrew I.R. Maas; David van Klaveren
• Keywords: Glasgow Outcome Scale

After mild traumatic brain injury (mTBI), a substantial proportion of individuals do not fully recover on the Glasgow Outcome Scale Extended (GOSE) or experience persistent post-concussion symptoms (PPCS). We aimed to develop prognostic models for GOSE and PPCS at 6 months after mTBI assess value different categories predictors (clinical variables; questionnaires; computed tomography [CT]; blood biomarkers). From Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study, we included participants aged 16 older with Coma Score (GCS) 13-15. used ordinal logistic regression model relationship between GOSE, linear Rivermead Post-concussion Symptoms Questionnaire (RPQ) total score. First, studied pre-specified Core model. Next, extended other clinical sociodemographic variables available presentation (Clinical model). The Clinical was then assessed before discharge from hospital: early symptoms, CT variables, biomarkers, all three (extended models). In subset patients mostly discharged home emergency department, 2-3-week mental health symptoms. Predictors were selected based Akaike's Information Criterion. Performance expressed as concordance index (C) performance variance explained (R2). Bootstrap validation correct optimism. 2376 6-month 1605 RPQ. showed moderate discrimination (C = 0.68 95% confidence interval 0.70 C 0.70[0.69 0.71], respectively) severity strongest predictor. had better discriminative ability 0.71[0.69 0.72] symptoms; 0.71[0.70 biomarkers; 0.72[0.71 0.73] categories). RPQ modest (R2 4% Core; R2 9% Clinical), extensions increased 12%. both outcomes these measured 0.74 [0.71 0.78] vs. 0.63[0.61 0.67] GOSE; 37% 6% RPQ). conclusion, have prediction poor PPCS. 2-3 weeks are required predictive outcomes. proposed should be examined independent cohorts.