Feasibility of Online Traumatic Brain Injury Prognostic Corticosteroids Randomisation After Significant Head Injury (CRASH) Model as a Predictor of Mortality.

BACKGROUND: Traumatic brain injury (TBI) is a major cause of mortality in many countries. According to the World Health Organization, traffic crashes are a leading cause of death, with 1.25 million deaths worldwide in 2013. A 2013 global road safety report listed 68 low-to-middle income countries that had an increased mortality rate owing to traffic accidents. The aim of this study was to analyze feasibility of use of an online prognostic model from the Medical Research Council Corticosteroids Randomization After Significant Head Injury (CRASH) trial collaborators in our center.

METHODS: This is a cross-sectional retrospective study of 229 patients with TBI who were admitted to the Neurosurgery Unit at Dr. Hasan Sadikin Hospital, Bandung, from July to December 2016.

RESULTS: During the study period, 495 patients with TBI were admitted; 229 patients were included in the study. Several variables were analyzed using independent statistical methods before being included in the online CRASH calculator, including Glasgow Coma Scale score (P = 0.000), pupillary reaction to light (P = 0.000), major extracranial injury (P = 0.002), and interval following incidence (P = 0.000). Statistical analysis showed that the online CRASH prognostic model reliably predicted 14-day mortality rate (P = 0.000) with 91.6% sensitivity and 95.1% specificity.

CONCLUSIONS: The online CRASH model is a good prognostic model that can be used for patients with TBI in many developing countries.