Utilization of clinical and radiological parameters to predict cognitive prognosis in patients with mild-to-moderate traumatic brain injury
BackgroundCognitive impairment is a common sequela following traumatic brain injury (TBI). This study aimed to identify risk factors for cognitive impairment after 3 and 12 months of TBI and to create nomograms to predict them.MethodsA total of 305 mild-to-moderate TBI patients admitted to the First...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2023-07-01
|
| Series: | Frontiers in Neuroscience |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fnins.2023.1222541/full |
| _version_ | 1797771279254683648 |
|---|---|
| author | Xi Wang Xiaobo Hui Xiaobo Hui Xiangyu Wang Baosheng Huang Xiaokui Gan Xingdong Liu Zhiyan Shen Yi Sun Lixin Li |
| author_facet | Xi Wang Xiaobo Hui Xiaobo Hui Xiangyu Wang Baosheng Huang Xiaokui Gan Xingdong Liu Zhiyan Shen Yi Sun Lixin Li |
| author_sort | Xi Wang |
| collection | DOAJ |
| description | BackgroundCognitive impairment is a common sequela following traumatic brain injury (TBI). This study aimed to identify risk factors for cognitive impairment after 3 and 12 months of TBI and to create nomograms to predict them.MethodsA total of 305 mild-to-moderate TBI patients admitted to the First Affiliated Hospital with Nanjing Medical University from January 2018 to January 2022 were retrospectively recruited. Risk factors for cognitive impairment after 3 and 12 months of TBI were identified by univariable and multivariable logistic regression analyses. Based on these factors, we created two nomograms to predict cognitive impairment after 3 and 12 months of TBI, the discrimination and calibration of which were validated by plotting the receiver operating characteristic (ROC) curve and calibration curve, respectively.ResultsCognitive impairment was detected in 125/305 and 52/305 mild-to-moderate TBI patients after 3 and 12 months of injury, respectively. Age, the Glasgow Coma Scale (GCS) score, >12 years of education, hyperlipidemia, temporal lobe contusion, traumatic subarachnoid hemorrhage (tSAH), very early rehabilitation (VER), and intensive care unit (ICU) admission were independent risk factors for cognitive impairment after 3 months of mild-to-moderate TBI. Meanwhile, age, GCS score, diabetes mellitus, tSAH, and surgical treatment were independent risk factors for cognitive impairment after 12 months of mild-to-moderate TBI. Two nomograms were created based on the risk factors identified using logistic regression analyses. The areas under the curve (AUCs) of the two nomograms to predict cognitive impairment after 3 and 12 months of mild-to-moderate TBI were 0.852 (95% CI [0.810, 0.895]) and 0.817 (95% CI [0.762, 0.873]), respectively.ConclusionTwo nomograms are created to predict cognitive impairment after 3 and 12 months of TBI. Age, GCS score, >12 years of education, hyperlipidemia, temporal lobe contusion, tSAH, VER, and ICU admission are independent risk factors for cognitive impairment after 3 months of TBI; meanwhile, age, the GCS scores, diabetes mellitus, tSAH, and surgical treatment are independent risk factors of cognitive impairment after 12 months of TBI. Two nomograms, based on both groups of factors, respectively, show strong discriminative abilities. |
| first_indexed | 2024-03-12T21:35:14Z |
| format | Article |
| id | doaj.art-23727cf82e484b18a40a8d8d88b292b1 |
| institution | Directory Open Access Journal |
| issn | 1662-453X |
| language | English |
| last_indexed | 2024-03-12T21:35:14Z |
| publishDate | 2023-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neuroscience |
| spelling | doaj.art-23727cf82e484b18a40a8d8d88b292b12023-07-27T09:44:14ZengFrontiers Media S.A.Frontiers in Neuroscience1662-453X2023-07-011710.3389/fnins.2023.12225411222541Utilization of clinical and radiological parameters to predict cognitive prognosis in patients with mild-to-moderate traumatic brain injuryXi Wang0Xiaobo Hui1Xiaobo Hui2Xiangyu Wang3Baosheng Huang4Xiaokui Gan5Xingdong Liu6Zhiyan Shen7Yi Sun8Lixin Li9Department of Neurosurgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, ChinaDepartment of Neurosurgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, ChinaDepartment of Neurosurgery, The Affiliated Huaian No. 1 People's Hospital of Nanjing Medical University, Huaian, Jiangsu, ChinaDepartment of Rehabilitation Medicine, The Affiliated Lianyungang Oriental Hospital of Kangda College of Nanjing Medical University, Lianyungang, Jiangsu, ChinaDepartment of Neurosurgery, Sir Run Run Hospital, Nanjing Medical University, Nanjing, ChinaDepartment of Neurosurgery, Sir Run Run Hospital, Nanjing Medical University, Nanjing, ChinaDepartment of Neurosurgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, ChinaDepartment of Neurosurgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, ChinaDepartment of Neurosurgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, ChinaDepartment of Neurosurgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, ChinaBackgroundCognitive impairment is a common sequela following traumatic brain injury (TBI). This study aimed to identify risk factors for cognitive impairment after 3 and 12 months of TBI and to create nomograms to predict them.MethodsA total of 305 mild-to-moderate TBI patients admitted to the First Affiliated Hospital with Nanjing Medical University from January 2018 to January 2022 were retrospectively recruited. Risk factors for cognitive impairment after 3 and 12 months of TBI were identified by univariable and multivariable logistic regression analyses. Based on these factors, we created two nomograms to predict cognitive impairment after 3 and 12 months of TBI, the discrimination and calibration of which were validated by plotting the receiver operating characteristic (ROC) curve and calibration curve, respectively.ResultsCognitive impairment was detected in 125/305 and 52/305 mild-to-moderate TBI patients after 3 and 12 months of injury, respectively. Age, the Glasgow Coma Scale (GCS) score, >12 years of education, hyperlipidemia, temporal lobe contusion, traumatic subarachnoid hemorrhage (tSAH), very early rehabilitation (VER), and intensive care unit (ICU) admission were independent risk factors for cognitive impairment after 3 months of mild-to-moderate TBI. Meanwhile, age, GCS score, diabetes mellitus, tSAH, and surgical treatment were independent risk factors for cognitive impairment after 12 months of mild-to-moderate TBI. Two nomograms were created based on the risk factors identified using logistic regression analyses. The areas under the curve (AUCs) of the two nomograms to predict cognitive impairment after 3 and 12 months of mild-to-moderate TBI were 0.852 (95% CI [0.810, 0.895]) and 0.817 (95% CI [0.762, 0.873]), respectively.ConclusionTwo nomograms are created to predict cognitive impairment after 3 and 12 months of TBI. Age, GCS score, >12 years of education, hyperlipidemia, temporal lobe contusion, tSAH, VER, and ICU admission are independent risk factors for cognitive impairment after 3 months of TBI; meanwhile, age, the GCS scores, diabetes mellitus, tSAH, and surgical treatment are independent risk factors of cognitive impairment after 12 months of TBI. Two nomograms, based on both groups of factors, respectively, show strong discriminative abilities.https://www.frontiersin.org/articles/10.3389/fnins.2023.1222541/fulltraumatic brain injurycognitive impairmentpredictive factornomogramradiological parameters |
| spellingShingle | Xi Wang Xiaobo Hui Xiaobo Hui Xiangyu Wang Baosheng Huang Xiaokui Gan Xingdong Liu Zhiyan Shen Yi Sun Lixin Li Utilization of clinical and radiological parameters to predict cognitive prognosis in patients with mild-to-moderate traumatic brain injury Frontiers in Neuroscience traumatic brain injury cognitive impairment predictive factor nomogram radiological parameters |
| title | Utilization of clinical and radiological parameters to predict cognitive prognosis in patients with mild-to-moderate traumatic brain injury |
| title_full | Utilization of clinical and radiological parameters to predict cognitive prognosis in patients with mild-to-moderate traumatic brain injury |
| title_fullStr | Utilization of clinical and radiological parameters to predict cognitive prognosis in patients with mild-to-moderate traumatic brain injury |
| title_full_unstemmed | Utilization of clinical and radiological parameters to predict cognitive prognosis in patients with mild-to-moderate traumatic brain injury |
| title_short | Utilization of clinical and radiological parameters to predict cognitive prognosis in patients with mild-to-moderate traumatic brain injury |
| title_sort | utilization of clinical and radiological parameters to predict cognitive prognosis in patients with mild to moderate traumatic brain injury |
| topic | traumatic brain injury cognitive impairment predictive factor nomogram radiological parameters |
| url | https://www.frontiersin.org/articles/10.3389/fnins.2023.1222541/full |
| work_keys_str_mv | AT xiwang utilizationofclinicalandradiologicalparameterstopredictcognitiveprognosisinpatientswithmildtomoderatetraumaticbraininjury AT xiaobohui utilizationofclinicalandradiologicalparameterstopredictcognitiveprognosisinpatientswithmildtomoderatetraumaticbraininjury AT xiaobohui utilizationofclinicalandradiologicalparameterstopredictcognitiveprognosisinpatientswithmildtomoderatetraumaticbraininjury AT xiangyuwang utilizationofclinicalandradiologicalparameterstopredictcognitiveprognosisinpatientswithmildtomoderatetraumaticbraininjury AT baoshenghuang utilizationofclinicalandradiologicalparameterstopredictcognitiveprognosisinpatientswithmildtomoderatetraumaticbraininjury AT xiaokuigan utilizationofclinicalandradiologicalparameterstopredictcognitiveprognosisinpatientswithmildtomoderatetraumaticbraininjury AT xingdongliu utilizationofclinicalandradiologicalparameterstopredictcognitiveprognosisinpatientswithmildtomoderatetraumaticbraininjury AT zhiyanshen utilizationofclinicalandradiologicalparameterstopredictcognitiveprognosisinpatientswithmildtomoderatetraumaticbraininjury AT yisun utilizationofclinicalandradiologicalparameterstopredictcognitiveprognosisinpatientswithmildtomoderatetraumaticbraininjury AT lixinli utilizationofclinicalandradiologicalparameterstopredictcognitiveprognosisinpatientswithmildtomoderatetraumaticbraininjury |