Development and validation of a nomogram for predicting early neurological deterioration in patients with moderate traumatic brain injury: a retrospective analysis
ObjectiveEarly neurological deterioration (END) greatly affects prognosis of moderate traumatic brain injury (TBI). This study aimed to develop and validate a nomogram to predict the occurrence of END in patients with moderate TBI.MethodsA total of 371 patients with moderate TBI were enrolled and di...
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Frontiers Media S.A.
2025-02-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2025.1512125/full |
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| author | Shen Wang Shen Wang Ruhai Wang Chao Han Haicheng Hu Hongtao Sun Hongtao Sun |
| author_facet | Shen Wang Shen Wang Ruhai Wang Chao Han Haicheng Hu Hongtao Sun Hongtao Sun |
| author_sort | Shen Wang |
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| description | ObjectiveEarly neurological deterioration (END) greatly affects prognosis of moderate traumatic brain injury (TBI). This study aimed to develop and validate a nomogram to predict the occurrence of END in patients with moderate TBI.MethodsA total of 371 patients with moderate TBI were enrolled and divided into the training (n = 260) and validation (n = 111) groups at a ratio of 7:3. Univariate and multivariate logistic regression analyses were used to identify the significant factors for END, which were used to develop a nomogram. The discrimination of the nomogram was evaluated using area under the receiver operating characteristic curves (AUC), the calibration was evaluated using calibration curves and Hosmer-Lemeshow tests. Decision curve analysis (DCA) was used to evaluate the net benefit of the model for patients.ResultsIn the training group, multivariate logistic regression demonstrated that GCS score, epidural hematoma, intracerebral hemorrhage, fibrinogen, and D-dimer were independent risk factors for END in patients with moderate TBI. A nomogram was constructed using the logistic regression prediction model. The AUCs of the nomogram in the training and validation groups were 0.901 and 0.927, respectively. The calibration curves showed that the predicted probability was consistent with the actual situation in both the training and validation sets. DCA curves demonstrated significantly better net benefit with the model. Then a web-based calculator was generated to facilitate clinical application.ConclusionThe present study developed and validated a model to predict END in patients with moderate TBI. The nomogram that had good discrimination, calibration, and clinical utility can provide clinicians with an effective and accurate tool for evaluating the occurrence of END after moderate TBI. |
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| institution | Kabale University |
| issn | 1664-2295 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Neurology |
| spelling | doaj-art-6ef57cfb2b374346a9178d84025babc12025-02-05T05:17:39ZengFrontiers Media S.A.Frontiers in Neurology1664-22952025-02-011610.3389/fneur.2025.15121251512125Development and validation of a nomogram for predicting early neurological deterioration in patients with moderate traumatic brain injury: a retrospective analysisShen Wang0Shen Wang1Ruhai Wang2Chao Han3Haicheng Hu4Hongtao Sun5Hongtao Sun6The First School of Clinical Medical, Lanzhou University, Lanzhou, ChinaTianjin Key Laboratory of Neurotrauma Repair, Characteristic Medical Center of People’s Armed Police Forces, Tianjin, ChinaDepartment of Neurosurgery, Fuyang Fifth People’s Hospital, Anhui, ChinaDepartment of Neurosurgery, Fuyang Fifth People’s Hospital, Anhui, ChinaDepartment of Neurosurgery, Fuyang Fifth People’s Hospital, Anhui, ChinaThe First School of Clinical Medical, Lanzhou University, Lanzhou, ChinaTianjin Key Laboratory of Neurotrauma Repair, Characteristic Medical Center of People’s Armed Police Forces, Tianjin, ChinaObjectiveEarly neurological deterioration (END) greatly affects prognosis of moderate traumatic brain injury (TBI). This study aimed to develop and validate a nomogram to predict the occurrence of END in patients with moderate TBI.MethodsA total of 371 patients with moderate TBI were enrolled and divided into the training (n = 260) and validation (n = 111) groups at a ratio of 7:3. Univariate and multivariate logistic regression analyses were used to identify the significant factors for END, which were used to develop a nomogram. The discrimination of the nomogram was evaluated using area under the receiver operating characteristic curves (AUC), the calibration was evaluated using calibration curves and Hosmer-Lemeshow tests. Decision curve analysis (DCA) was used to evaluate the net benefit of the model for patients.ResultsIn the training group, multivariate logistic regression demonstrated that GCS score, epidural hematoma, intracerebral hemorrhage, fibrinogen, and D-dimer were independent risk factors for END in patients with moderate TBI. A nomogram was constructed using the logistic regression prediction model. The AUCs of the nomogram in the training and validation groups were 0.901 and 0.927, respectively. The calibration curves showed that the predicted probability was consistent with the actual situation in both the training and validation sets. DCA curves demonstrated significantly better net benefit with the model. Then a web-based calculator was generated to facilitate clinical application.ConclusionThe present study developed and validated a model to predict END in patients with moderate TBI. The nomogram that had good discrimination, calibration, and clinical utility can provide clinicians with an effective and accurate tool for evaluating the occurrence of END after moderate TBI.https://www.frontiersin.org/articles/10.3389/fneur.2025.1512125/fullmoderate traumatic brain injuryearly neurological deteriorationnomogramrisk factorsprediction model |
| spellingShingle | Shen Wang Shen Wang Ruhai Wang Chao Han Haicheng Hu Hongtao Sun Hongtao Sun Development and validation of a nomogram for predicting early neurological deterioration in patients with moderate traumatic brain injury: a retrospective analysis Frontiers in Neurology moderate traumatic brain injury early neurological deterioration nomogram risk factors prediction model |
| title | Development and validation of a nomogram for predicting early neurological deterioration in patients with moderate traumatic brain injury: a retrospective analysis |
| title_full | Development and validation of a nomogram for predicting early neurological deterioration in patients with moderate traumatic brain injury: a retrospective analysis |
| title_fullStr | Development and validation of a nomogram for predicting early neurological deterioration in patients with moderate traumatic brain injury: a retrospective analysis |
| title_full_unstemmed | Development and validation of a nomogram for predicting early neurological deterioration in patients with moderate traumatic brain injury: a retrospective analysis |
| title_short | Development and validation of a nomogram for predicting early neurological deterioration in patients with moderate traumatic brain injury: a retrospective analysis |
| title_sort | development and validation of a nomogram for predicting early neurological deterioration in patients with moderate traumatic brain injury a retrospective analysis |
| topic | moderate traumatic brain injury early neurological deterioration nomogram risk factors prediction model |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2025.1512125/full |
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