Abstract

This study aimed to investigate the prognostication of patients suffering from severe traumatic brain injury (TBI) through the assessment of clinical parameters, radiological findings, and biomarkers in a tertiary care hospital in Uttar Pradesh. Material & methods: A total of 200 patients with severe TBI were included in the study. Clinical parameters, including age, gender, mechanism of injury, associated injuries, and Glasgow Coma Scale (GCS) scores, were recorded. Radiological findings were obtained from computed tomography (CT) scans, and biomarker levels (S100B, neuron-specific enolase [NSE], and glial fibrillary acidic protein [GFAP]) were measured in blood samples collected within 24 hours of injury. The Glasgow Outcome Scale (GOS) was used to assess long-term prognosis. Multivariate analysis was conducted, and a prognostic model was developed. Results: The mean age of the patients was 45 years, with males representing 70% of the study population. Motor vehicle accidents were the most common mechanism of injury (45%), and associated injuries were observed in 60% of the patients. The distribution of initial GCS scores was as follows: GCS 3-5 (40%), GCS 6-8 (30%), and GCS 9-12 (30%). Radiological findings revealed subdural hematomas (35%), diffuse axonal injury (25%), and epidural hematomas (20%) as the most frequent patterns of brain injury. The frontal lobe (40%) was the most commonly affected brain region. Elevated levels of S100B (70%), NSE (55%), and GFAP (45%) were observed in the biomarker analysis. Higher GCS scores (9-12) were associated with a better prognosis, while elevated S100B levels were indicative of a poorer prognosis. CT scan findings, such as the presence of subdural hematomas and diffuse axonal injury, were associated with worse outcomes. The developed prognostic model demonstrated good discriminative ability, with an area under the ROC curve of 0.85.

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