Turkish Journal of Emergency Medicine

ORIGINAL ARTICLE
Year
: 2022  |  Volume : 22  |  Issue : 1  |  Page : 15--22

Development of a nomogram to predict the outcome of moderate or severe pediatric traumatic brain injury


Thakul Oearsakul, Thara Tunthanathip 
 Department of Surgery, Division of Neurosurgery, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand

Correspondence Address:
Dr. Thara Tunthanathip
Department of Surgery, Division of Neurosurgery, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla
Thailand

OBJECTIVES: Traumatic brain injury (TBI) in children has become the major cause of mortality and morbidity in Thailand that has had an impact with economic consequences. This study aimed to develop and internally validate a nomogram for a 6-month follow-up outcome prediction in moderate or severe pediatric TBI. METHODS: This retrospective cohort study involved 104 children with moderate or severe TBI. Various clinical variables were reviewed. The functional outcome was assessed at the hospital discharge and at a 6-month follow-up based on the King's Outcome Scale for Childhood Head Injury classification. Predictors associated with the 6-month follow-up outcome were developed from the predictive model using multivariable binary logistic regression to estimate the performance and internal validation. A nomogram was developed and presented as a predictive model. RESULTS: The mean age of the samples was 99.75 months (standard deviation 59.65). Road traffic accidents were the highest injury mechanism at 84.6%. The predictive model comprised Glasgow Coma Scale of 3–8 (odds ratio [OR]: 16.07; 95% confidence interval [CI]: 1.27–202.42), pupillary response in one eye (OR 7.74; 95% CI 1.26–47.29), pupillary nonresponse in both eyes (OR: 57.74; 95% CI: 2.28–145.81), hypotension (OR: 19.54; 95%: CI 3.23–117.96), and subarachnoid hemorrhage (OR: 9.01, 95% CI: 1.33–60.80). The concordance statistic index (C-index) of the model's discrimination was 0.931, while the C-index following the bootstrapping and 5-cross validation were 0.920 and 0.924, respectively. CONCLUSIONS: The performance of a clinical nomogram for predicting 6-month follow-up outcomes in pediatric TBI patients was assessed at an excellent level. However, further external validation would be required for the confirmation of the tool's performance.


How to cite this article:
Oearsakul T, Tunthanathip T. Development of a nomogram to predict the outcome of moderate or severe pediatric traumatic brain injury.Turk J Emerg Med 2022;22:15-22


How to cite this URL:
Oearsakul T, Tunthanathip T. Development of a nomogram to predict the outcome of moderate or severe pediatric traumatic brain injury. Turk J Emerg Med [serial online] 2022 [cited 2022 Jun 25 ];22:15-22
Available from: https://www.turkjemergmed.org/article.asp?issn=2452-2473;year=2022;volume=22;issue=1;spage=15;epage=22;aulast=Oearsakul;type=0