Prognostics of Hospitalization Length and Mortality in Patients with Traumatic Frontal Brain Contusions

Abstract

Traumatic brain injury has ripple effect on the physical, cognitive, behavioral, and emotional domains of quality of life and portends a long-term neurological disability in survivors. In this study we evaluated the prognostic role of demographic and clinico-radiological variables on the hospitalization length and mortality in 71 of patients with frontal brain contusions. The receiver operating characteristic (ROC) plots were performed, with area under the curve (AUC) values, for graphical comparison of variables that would predict mortality and hospitalization length. We found that the best prognostics of mortality were the Glasgow Coma Scale score, the motor function score, and the Rotterdam CT score, with AUC values of 0.873, 0.836, and 0.711, respectively. Concerning the prediction of hospitalization length, the AUC showed inappreciable differences, with the highest values for the Glasgow Coma Scale score, Rotterdam CT score, and the serum cortisol level in a 0.550–0.600 range. Curve estimation, based on multivariate analysis, showed that the scores of motor function, Glasgow Coma Scale, and Rotterdam CT correlated best with the prediction of both mortality and hospitalization length, along with the upward dynamic changes of serum cortisol for the latter. We conclude that basically simple and non-invasive assessment in survivors of acute traumatic brain contusion is helpful in predicting mortality and the length of hospital stay, which would be of essential value in better allocation of healthcare resources for inpatient treatment and rehabilitation and for post-hospital patient’s functioning.