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Chinese Admission Warning Strategy for Predicting the Hospital Discharge Outcome in Patients with Traumatic Brain Injury

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机构: [1]Hosp Dev Ctr, Shanghai 200041, Peoples R China [2]Fudan Univ, Huashan Hosp, Dept Neurosurg, Shanghai 200040, Peoples R China [3]Tongji Univ, Shanghai East Hosp, Dept Neurosurg, Sch Med, Shanghai 200120, Peoples R China [4]Shanghai Jiao Tong Univ, Tongren Hosp, Dept Neurosurg, Sch Med, Shanghai 200336, Peoples R China [5]Shanghai Jiao Tong Univ, Shanghai Peoples Hosp 9, Dept Intervent Therapy, Sch Med, Shanghai 201999, Peoples R China [6]Shanghai Jiao Tong Univ, Sch Elect Informat & Elect Engn, Dept Automat, Shanghai 200240, Peoples R China [7]Shanghai Jiao Tong Univ, Xinhua Hosp, Dept Emergency, Sch Med, Shanghai 200092, Peoples R China [8]Shanghai Jiao Tong Univ, Tongren Hosp, Dept Neurol, Sch Med, Shanghai 200336, Peoples R China
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关键词: warning strategy admission hospital discharge outcome traumatic brain injury emergency

摘要:
Objective: To develop and validate an admission warning strategy that incorporates the general emergency department indicators for predicting the hospital discharge outcome of patients with traumatic brain injury (TBI) in China. Methods: This admission warning strategy was developed in a primary cohort that consisted of 605 patients with TBI who were admitted within 6 h of injury. The least absolute shrinkage and selection operator and multivariable logistic regression analysis were used to develop the early warning strategy of selected indicators. Two sub-cohorts consisting of 180 and 107 patients with TBI were used for the external validation. Results: Indicators of the strategy included three categories: baseline characteristics, imaging and laboratory indicators. This strategy displayed good calibration and good discrimination. A high C-index was reached in the internal validation. The multicenter external validation cohort still showed good discrimination C-indices. Decision curve analysis (DCA) showed the actual needs of this strategy when the possibility threshold was 0.01 for the primary cohort, and at thresholds of 0.02-0.83 and 0.01-0.88 for the two sub-cohorts, respectively. In addition, this strategy exhibited a significant prognostic capacity compared to the traditional single predictors, and this optimization was also observed in two external validation cohorts. Conclusions: We developed and validated an admission warning strategy that can be quickly deployed in the emergency department. This strategy can be used as an ideal tool for predicting hospital discharge outcomes and providing objective evidence for early informed consent of the hospital discharge outcome to the family members of TBI patients.

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出版当年[2021]版:
大类 | 3 区 医学
小类 | 2 区 医学:内科
最新[2023]版:
大类 | 3 区 医学
小类 | 2 区 医学:内科
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出版当年[2020]版:
Q1 MEDICINE, GENERAL & INTERNAL
最新[2023]版:
Q1 MEDICINE, GENERAL & INTERNAL

影响因子: 最新[2023版] 最新五年平均 出版当年[2020版] 出版当年五年平均 出版前一年[2019版] 出版后一年[2021版]

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第一作者机构: [1]Hosp Dev Ctr, Shanghai 200041, Peoples R China [2]Fudan Univ, Huashan Hosp, Dept Neurosurg, Shanghai 200040, Peoples R China
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