Severe head injuries: an outcome prediction and survival analysis

Intensive Care Med. 1996 Dec;22(12):1391-5. doi: 10.1007/BF01709556.


Objective: To identify the predictors determined early after admission and associated with unfavorable outcome or early (within 48 h) death after severe head injury.

Design: Prospective cohort study.

Setting: A neurosurgical intensive care unit in a university hospital.

Patients: 198 consecutive comatose patients hospitalized from 1989 to 1992.

Results: Logistic regression showed that a combination of age, best motor response score from the Glasgow Coma Scale, and hypoxia provided a good prediction model of unfavorable outcome (sensitivity = 0.93). The length of participation of survivors was 6 to 61 months (median 27.1). The Cox model demonstrated age, motor score less than 3, mydriasis, and hypoxia as poor prognosis factors.

Conclusions: Clinicians can determine the odds of a good outcome from the combination of three easily measurable factors using a simple diagram constructed from logistic regression. Survival analysis showed that motor score adjusted values greater than 3 had the same prognosis.

MeSH terms

  • Adult
  • Aged
  • Craniocerebral Trauma / mortality
  • Craniocerebral Trauma / therapy*
  • Critical Care*
  • Female
  • Glasgow Coma Scale
  • Hospital Mortality*
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Proportional Hazards Models
  • Prospective Studies
  • Sensitivity and Specificity
  • Severity of Illness Index*
  • Survival Analysis
  • Time Factors
  • Treatment Outcome