Abstract
ObjectiveTo evaluate fever burden as an independent predictor for prognosis of traumatic brain injury (TBI).MethodsThis retrospective study involved 355 TBI patients with Glasgow Coma Scale (GCS) ≤14, who presented at the emergency department of our hospital between November 2010 and October 2012. At 6 months follow-up, patients were divided into 5 groups based on Glasgow Outcome Scale (GOS) and dichotomized to GOS score (high (4 to 5) vs. low (1 to 3)). The relationship between fever burden and GOS was assessed.ResultsFever burden increased as GOS scores decreased from 5 to 2, except for score 1 of GOS, which corresponded to a significant lower fever burden. Following dichotomization, patients in the high GOS group were younger, and showed less abnormal pupil reactivity (P<0.001), a higher median GCS score (P<0.001), and a lower median fever burden (P<0.001), compared with patients in the low GOS group. Univariate logistic regression analysis revealed that poor TBI prognosis was related to age, GCS, pupil reactivity, and fever burden (OR: 1.166 [95% CI: 1.117–1.217] P<0.0001). Multivariate logistic regression analysis identified fever burden as an independent predictor of poor prognosis after TBI (OR 1.098; 95% CI: 1.031–1.169; P = 0.003). These observations were confirmed by evaluation of the receiver operating characteristic (ROC) curve for fever burden (area under the curve [AUC] 0.73 [95% CI: 0.663–0.760]).ConclusionFever burden might be an independent predictor for prognosis of TBI. High fever burden in the early stage of the disease course associated with TBI could increase the risk of poor prognosis.
Highlights
Traumatic brain injury (TBI) is a common cause of injury, death, and disability in people younger than 40 years
Three approaches to outcome prediction following TBI are available: the first is based on admission characteristics, including age, Glasgow Coma Scale (GCS) score, pupil reactivity, blood glucose levels, and presence of major extracraninal injury; the second is represented by the Marshall computed tomographic (CT) classification, and is based on pathological findings seen on the first available CT scan; and the third uses serum or cerebrospinal fluid (CSF) biomarker levels [4]
Our findings strongly suggest that age, GCS and pupil reactivity are precise and valid predictors for prognosis in TBI patients
Summary
Traumatic brain injury (TBI) is a common cause of injury, death, and disability in people younger than 40 years. It is predicted that TBI will be the third most common cause of death in 20 years [2]. The prognosis of TBI varies depending on the type and location of the injury, the associated pathology, and the severity of lesions (quantified using the Glasgow Coma Scale (GCS)). Three approaches to outcome prediction following TBI are available: the first is based on admission characteristics, including age, Glasgow Coma Scale (GCS) score, pupil reactivity, blood glucose levels, and presence of major extracraninal injury; the second is represented by the Marshall computed tomographic (CT) classification, and is based on pathological findings seen on the first available CT scan; and the third uses serum or cerebrospinal fluid (CSF) biomarker levels [4]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
