Li Tian, Zhuang Dongzhou, Cai Shirong, Ding Faxiu, Tian Fei, Huang Mindong, Li Lianjie, Chen Weiqiang, Li Kangsheng, Sheng Jiangtao
Shantou University Medical College, Department of Microbiology and Immunology & Guangdong Provincial Key Laboratory of Infectious Diseases and Molecular Immunopathology, Shantou, Guangdong, China.
First Affiliated Hospital of Shantou University Medical College, Department of Neurosurgery, Shantou, Guangdong, China.
Heliyon. 2023 Jul 25;9(8):e18475. doi: 10.1016/j.heliyon.2023.e18475. eCollection 2023 Aug.
Accurate and convenient serological markers for prognosis after traumatic brain injury (TBI) are still lacking. We aimed to explore the predictive value of serum calcium for prognosing outcomes within 6 months after TBI.
In this multicenter retrospective study, 1255 and 719 patients were included in development and validation cohorts, respectively, and their 6-month prognoses were recorded. Serum calcium was measured through routine blood tests within 24 h of hospital admission. Two multivariate predictive models with or without serum calcium for prognosis were developed. Receiver operating characteristics and calibration curves were applied to estimate their performance.
The patients with lower serum calcium levels had a higher frequency of unfavorable 6-month prognosis than those without. Lower serum calcium level at admission was associated with an unfavorable 6-month prognosis in a wide spectrum of patients with TBI. Lower serum calcium level and our prognostic model including calcium performed well in predicting the 6-month unfavorable outcome. The calcium nomogram maintained excellent performance in discrimination and calibration in the external validation cohort.
Lower serum calcium level upon admission is an independent risk factor for an unfavorable 6-month prognosis after TBI. Integrating serum calcium into a multivariate predictive model improves the performance for predicting 6-month unfavorable outcomes.
创伤性脑损伤（TBI）后仍缺乏准确、便捷的血清学预后标志物。我们旨在探讨血清钙对TBI后6个月内预后的预测价值。
在这项多中心回顾性研究中，分别有1255例和719例患者纳入开发队列和验证队列，并记录他们6个月的预后情况。入院24小时内通过常规血液检测测定血清钙。建立了有或无血清钙的两种多变量预后预测模型。应用受试者工作特征曲线和校准曲线评估其性能。
血清钙水平较低的患者6个月预后不良的频率高于血清钙水平正常的患者。入院时血清钙水平较低与广泛的TBI患者6个月预后不良相关。较低的血清钙水平以及我们包含钙的预后模型在预测6个月不良结局方面表现良好。钙列线图在外部验证队列中的鉴别和校准性能优异。
入院时血清钙水平较低是TBI后6个月预后不良的独立危险因素。将血清钙纳入多变量预测模型可提高预测6个月不良结局的性能。
