Choi S C, Narayan R K, Anderson R L, Ward J D
Department of Biostatistics, Medical College of Virginia, Virginia Commonwealth University, Richmond.
J Neurosurg. 1988 Sep;69(3):381-5. doi: 10.3171/jns.1988.69.3.0381.
Data from 523 patients admitted to the Medical College of Virginia with severe head injury and known 6-month outcomes were analyzed in order to determine the optimal combination of early-available prognostic factors. Twenty-one prognostic indicators noted in the emergency room at admission were used to predict outcomes into four categories: good, moderately disabled, severely disabled, or vegetative/dead. A combination of the patient's age (in years), the best motor response (graded in the usual six-point scale), and pupillary response (in both eyes) was found to be the most accurate indicator. The model correctly predicted outcome into one of the four outcome categories in 78% of cases ("specifically accurate predictions"). If predictions into an outcome category adjacent to the actual outcome were accepted, this model was accurate in 90% of cases ("grossly accurate predictions"). A set of three simple graphs based on this model can be used for rapid early estimation of probable outcome in a severely head-injured patient at admission.
对弗吉尼亚医学院收治的523例重度颅脑损伤患者的数据以及已知的6个月预后情况进行了分析，以确定早期可得的预后因素的最佳组合。入院时在急诊室记录的21项预后指标被用于预测预后情况，分为四类：良好、中度残疾、重度残疾或植物人/死亡。结果发现，患者的年龄（以岁为单位）、最佳运动反应（按常用的六点量表分级）和瞳孔反应（双眼）的组合是最准确的指标。该模型在78%的病例中正确地将预后预测为四个预后类别之一（“特别准确的预测”）。如果接受将预后预测为与实际预后相邻的类别，该模型在90%的病例中是准确的（“大致准确的预测”）。基于该模型的一组三张简单图表可用于在重度颅脑损伤患者入院时快速早期估计可能的预后情况。
