Inpatient Metabolic Panel Trajectories Improve 6-Month Mortality Prognostication after Severe Traumatic Brain Injury.
Adding lab trajectories improves 6-month mortality prediction after severe traumatic brain injury
Inpatient Metabolic Panel Trajectories Improve 6-Month Mortality Prognostication after Severe Traumatic Brain Injury.
The International Mission for Prognosis and Analysis of Clinical Trials (International Mission for Prognosis and Analysis of Clinical Trials) in traumatic brain injury (traumatic brain injury) only includes data from hospital admission as predictors.
We sought to evaluate differences in the daily trajectory of clinical metabolic panels (e.g., glucose, sodium, platelets, hemoglobin) for the first 7 days post-severe traumatic brain injury (sTBI).
This is a prospective cohort study of patients with sTBI with Glasgow Coma Scale (Glasgow Coma Scale) ≤8.
adding lab trends predicts survival slightly better than admission data alone
We compared daily metabolic panel trajectories between survivors to 6 months and nonsurvivors to 6 months using ordinal mixed-effects models.
We then examined the added prognostic value of these trajectories compared with the International Mission for Prognosis and Analysis of Clinical Trials-extended model for 6-month mortality.
The likelihood ratio tests (likelihood ratio tests) comparing the ordinal trajectories of sodium and platelets were statistically significant after false discovery correction (sodium: likelihood ratio = 51.0; adj. p < 0.001; platelets: likelihood ratio = 16.0; adj. p = 0.003), indicating that the overall trajectory over 7 days differs between groups.
Trajectory of metabolic panel labs in the first week postinjury yields meaningful improvements in prognostic ability for the individual patient.