San Francisco, California —Recent research by UC San Francisco, UC San Diego, and other U.S. institutions suggests a need to update the prognostic models used by many hospitals to predict outcomes for traumatic brain injury (TBI) patients. The International Mission on Prognosis and Analysis of Clinical Trials in TBI (IMPACT) and Corticosteroid Randomization After Head Injury (CRASH) models, developed between 1984 and 2004, may not fully account for advancements in TBI treatment over the past two decades.
The study, published in the Journal of Neurosurgery, compared outcomes predicted by these older models with real-world results from the Transforming Research and Clinical Knowledge in Traumatic Brain Injury (TRACK-TBI) study, conducted from 2014-2018 at 18 U.S. Level 1 trauma centers. The analysis, involving 831 patients, revealed lower TBI mortality rates than anticipated.
Dr. Geoffrey T. Manley, co-senior author of the study, notes the evolving nature of TBI care and understanding. The study also highlights limitations in current models, especially for older patients and those with moderate TBI, due to the diverse nature of TBI cases.
The research emphasizes the need for more personalized prognostic approaches, considering factors like protein biomarkers and patient frailty, to enhance TBI assessment and recovery strategies. The findings encourage a holistic view of TBI management, integrating medical, social, and rehabilitative care for improved patient outcomes.
