Components of traumatic brain injury severity indices

Short Title:
Components of traumatic brain injury severity indices
Model System:
Reference Type:
Journal Article
Accession No.:
Journal of Neurotrauma
Year, Volume, Issue, Page(s):
2014, vol. 1, issue 31, pp 1000-1007
Publication Website:
Study investigated whether there are underlying dimensions common among traditional traumatic brain injury (TBI) severity indices and, if so, the extent to which they are interchangeable when predicting short-term outcomes. The sample consisted of 77,470 adult cases reported to the National Trauma Data Bank from 2007 to 2010, with a diagnosis of TBI. There were no interventions. Severity indices used were the emergency department Glasgow Coma Scale total score and each of the subscales for eye opening, verbal response, and motor response; the worst Abbreviated Injury Scale severity score for the head; and the worst Barell index type. Prediction models were computed for acute care length of stay (days), intensive care unit length of stay (days), hospital discharge status (alive or dead), and, if alive, discharge disposition (home versus institutional). Multiple correspondence analysis (MCA) indicated a two-dimensional relationship among items of severity indexes. The primary dimension reflected overall injury severity. The second dimension seemed to capture volitional behavior without the capability for cogent responding. Together, they defined two vectors around which most of the items clustered. A scale that took advantage of the order of items along these vectors proved to be the most consistent index for predicting short-term health outcomes. MCA provided useful insight into the relationships among components of traditional TBI severity indices. The two-vector pattern may reflect the impact of injury on different cortical and subcortical networks. Results are discussed in terms of score substitution and the ability to impute missing values.
Corrigan, JD, Kreider, S, Cuthbert, J, Whyte, J, Dams-O'Connor, K, Faul, M, Harrison-Felix, CL, Whiteneck, G, Pretz, CR
Author Address(es):

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