PDF(Pubmed)
Abstract：
UNASSIGNED: The base deficit, international normalized ratio, and Glasgow Coma Scale (BIG) score was previously developed to predict the outcomes of pediatric trauma patients. We designed this study to explore and improve the prognostic value of the BIG score in adult patients with traumatic brain injury (TBI).
UNASSIGNED: Adult patients diagnosed with TBI in a public critical care database were included in this observational study. The BIG score was calculated based on the Glasgow Coma Scale (GCS), the international normalized ratio (INR), and the base deficit. Logistic regression analysis was performed to confirm the association between the BIG score and the outcome of included patients. Receiver operating characteristic (ROC) curves were drawn to evaluate the prognostic value of the BIG score and novel constructed models.
UNASSIGNED: In total, 1,034 TBI patients were included in this study with a mortality of 22.8%. Non-survivors had higher BIG scores than survivors (p < 0.001). The results of multivariable logistic regression analysis showed that age (p < 0.001), pulse oxygen saturation (SpO2) (p = 0.032), glucose (p = 0.015), hemoglobin (p = 0.047), BIG score (p < 0.001), subarachnoid hemorrhage (p = 0.013), and intracerebral hematoma (p = 0.001) were associated with in-hospital mortality of included patients. The AUC (area under the ROC curves) of the BIG score was 0.669, which was not as high as in previous pediatric trauma cohorts. However, combining the BIG score with age increased the AUC to 0.764. The prognostic model composed of significant factors including BIG had the highest AUC of 0.786.
UNASSIGNED: The age-adjusted BIG score is superior to the original BIG score in predicting mortality of adult TBI patients. The prognostic model incorporating the BIG score is beneficial for clinicians, aiding them in making early triage and treatment decisions in adult TBI patients.
UNASSIGNED: Adult patients diagnosed with TBI in a public critical care database were included in this observational study. The BIG score was calculated based on the Glasgow Coma Scale (GCS), the international normalized ratio (INR), and the base deficit. Logistic regression analysis was performed to confirm the association between the BIG score and the outcome of included patients. Receiver operating characteristic (ROC) curves were drawn to evaluate the prognostic value of the BIG score and novel constructed models.
UNASSIGNED: In total, 1,034 TBI patients were included in this study with a mortality of 22.8%. Non-survivors had higher BIG scores than survivors (p < 0.001). The results of multivariable logistic regression analysis showed that age (p < 0.001), pulse oxygen saturation (SpO2) (p = 0.032), glucose (p = 0.015), hemoglobin (p = 0.047), BIG score (p < 0.001), subarachnoid hemorrhage (p = 0.013), and intracerebral hematoma (p = 0.001) were associated with in-hospital mortality of included patients. The AUC (area under the ROC curves) of the BIG score was 0.669, which was not as high as in previous pediatric trauma cohorts. However, combining the BIG score with age increased the AUC to 0.764. The prognostic model composed of significant factors including BIG had the highest AUC of 0.786.
UNASSIGNED: The age-adjusted BIG score is superior to the original BIG score in predicting mortality of adult TBI patients. The prognostic model incorporating the BIG score is beneficial for clinicians, aiding them in making early triage and treatment decisions in adult TBI patients.
摘要：
■基本赤字，国际标准化比率，Glasgow昏迷量表(BIG)评分用于预测小儿创伤患者的预后.我们设计了这项研究，以探讨和改善BIG评分在成人创伤性脑损伤（TBI）患者的预后价值。
■在公共重症监护数据库中诊断为TBI的成年患者被纳入本观察性研究。根据格拉斯哥昏迷量表（GCS）计算BIG评分，国际标准化比率(INR)，基础赤字。进行Logistic回归分析以确认BIG评分与纳入患者的预后之间的关联。绘制受试者工作特征（ROC）曲线以评估BIG评分和新构建的模型的预后价值。
■总共，1,034例TBI患者纳入本研究，死亡率为22.8%。非幸存者的BIG评分高于幸存者（p<0.001）。多因素Logistic回归分析结果显示,年龄(p<0.001),脉搏血氧饱和度(SpO2)(p=0.032),葡萄糖（p=0.015），血红蛋白（p=0.047），BIG评分（p<0.001），蛛网膜下腔出血（p=0.013），和脑内血肿(p=0.001)与纳入患者的院内死亡率相关.BIG评分的AUC（ROC曲线下面积）为0.669，不如以前的儿科创伤队列高。然而,将BIG评分与年龄相结合,AUC增至0.764.由包括BIG在内的重要因素组成的预后模型具有0.786的最高AUC。
■年龄调整后的BIG评分在预测成年TBI患者死亡率方面优于原始BIG评分。结合BIG评分的预后模型对临床医生有益，帮助他们对成年TBI患者进行早期分诊和治疗决策。
■在公共重症监护数据库中诊断为TBI的成年患者被纳入本观察性研究。根据格拉斯哥昏迷量表（GCS）计算BIG评分，国际标准化比率(INR)，基础赤字。进行Logistic回归分析以确认BIG评分与纳入患者的预后之间的关联。绘制受试者工作特征（ROC）曲线以评估BIG评分和新构建的模型的预后价值。
■总共，1,034例TBI患者纳入本研究，死亡率为22.8%。非幸存者的BIG评分高于幸存者（p<0.001）。多因素Logistic回归分析结果显示,年龄(p<0.001),脉搏血氧饱和度(SpO2)(p=0.032),葡萄糖（p=0.015），血红蛋白（p=0.047），BIG评分（p<0.001），蛛网膜下腔出血（p=0.013），和脑内血肿(p=0.001)与纳入患者的院内死亡率相关.BIG评分的AUC（ROC曲线下面积）为0.669，不如以前的儿科创伤队列高。然而,将BIG评分与年龄相结合,AUC增至0.764.由包括BIG在内的重要因素组成的预后模型具有0.786的最高AUC。
■年龄调整后的BIG评分在预测成年TBI患者死亡率方面优于原始BIG评分。结合BIG评分的预后模型对临床医生有益，帮助他们对成年TBI患者进行早期分诊和治疗决策。
