Discover the latest breakthrough in neurotrauma surgery where a multicenter cohort study reveals how measuring absolute contusion expansion can significantly enhance the prediction of outcomes in traumatic brain injury patients.
– by The Don
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Absolute contusion expansion is superior to relative expansion in predicting traumatic brain injury outcomes: a multicenter observational cohort study.
Fletcher-Sandersjöö et al., J Neurotrauma 2023
DOI: 10.1089/neu.2023.0274
Listen folks, we’ve got something really important here, it’s about traumatic brain injury, TBI – a big deal, really big. We’re talking about contusion expansion, CE – it’s huge for predicting outcomes. Now, there’s been a lot of talk, no consensus, believe me. They don’t know how to measure it, absolute or relative volume, no idea about the cut-offs. We’re here to fix that, to find the best way to predict outcomes.
We did a massive study, adults with serious TBI, in the ICU, the best place for care. We looked at the scans, first and second, checked the changes in the contusions. We’re talking about real results – the Glasgow Outcome Scale, GOS, six to twelve months after injury. We’re looking for the best outcomes, favorable, not the bad ones.
Out of 798 patients, we found that the median time between scans was 7 hours. The median absolute CE? 1.5 ml. Relative? A whopping 100%. And guess what? Both are linked to the outcomes, but the absolute CE, it’s the winner. It’s better at predicting the bad outcomes and the mortality. We’re talking about an AUC of 0.65 versus 0.60 – it’s significant, folks.
And when we’re talking about cut-offs, absolute numbers, 1-10 ml, they’re the best, the very best. So, if you’re doing a study on TBI, you want to use absolute CE, it’s the strongest, the most correlated. And for the cut-offs, pick between 1-10 ml, depending on what you need. It’s clear, it’s decisive, it’s going to make a difference. That’s how you predict outcomes in TBI, with absolute CE. It’s going to be great.