Academic Journal
Multimodal assessment improves neuroprognosis performance in clinically unresponsive critical-care patients with brain injury
| Title: | Multimodal assessment improves neuroprognosis performance in clinically unresponsive critical-care patients with brain injury |
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| Authors: | Rohaut, B, Calligaris, C, Hermann, B, Perez, P, Faugeras, F, Raimondo, Federico, King, J-R, Engemann, D, Marois, C, Le Guennec, L, Di Meglio, L, Sangaré, A, Munoz Musat, E, Valente, M, Ben Salah, A, Demertzi, Athina, Belloli, L, Manasova, D, Jodaitis, L, Habert, M O, Lambrecq, V, Pyatigorskaya, N, Galanaud, D, Puybasset, L, Weiss, N, Demeret, S, Lejeune, F X, Sitt, J D, Naccache, L |
| Contributors: | JSMF - James S McDonnell Foundation, Rohaut, Benjamin |
| Source: | Nat Med |
| Publisher Information: | Springer Science and Business Media LLC, 2024. |
| Publication Year: | 2024 |
| Subject Terms: | Adult, Male, 0301 basic medicine, Sciences sociales & comportementales, psychologie, Critical Care, Glasgow Outcome Scale, Neuroimaging, Article, 03 medical and health sciences, 0302 clinical medicine, Humans, Neuroimaging/methods, Prospective Studies, Neurosciences & comportement, Aged, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, Biochemistry, Genetics and Molecular Biology (all), Neurosciences & behavior, Critical Care/methods, Middle Aged, Prognosis, 3. Good health, Brain Injuries/physiopathology, Social & behavioral sciences, psychology, Brain Injuries, Female |
| Description: | Accurately predicting functional outcomes for unresponsive patients with acute brain injury is a medical, scientific and ethical challenge. This prospective study assesses how a multimodal approach combining various numbers of behavioral, neuroimaging and electrophysiological markers affects the performance of outcome predictions. We analyzed data from 349 patients admitted to a tertiary neurointensive care unit between 2009 and 2021, categorizing prognoses as good, uncertain or poor, and compared these predictions with observed outcomes using the Glasgow Outcome Scale–Extended (GOS-E, levels ranging from 1 to 8, with higher levels indicating better outcomes). After excluding cases with life-sustaining therapy withdrawal to mitigate the self-fulfilling prophecy bias, our findings reveal that a good prognosis, compared with a poor or uncertain one, is associated with better one-year functional outcomes (common odds ratio (95% CI) for higher GOS-E: OR = 14.57 (5.70–40.32), P P P P = 0.011). Our results underscore the value of multimodal assessment in refining neuroprognostic precision, thereby offering a robust foundation for clinical decision-making processes for acutely brain-injured patients. ClinicalTrials.gov registration: NCT04534777. |
| Document Type: | Article Other literature type |
| File Description: | application/pdf |
| Language: | English |
| ISSN: | 1546-170X 1078-8956 |
| DOI: | 10.1038/s41591-024-03019-1 |
| Access URL: | https://pubmed.ncbi.nlm.nih.gov/38816609 |
| Rights: | CC BY |
| Accession Number: | edsair.doi.dedup.....aa528b9164b29a20a672932341d09f1f |
| Database: | OpenAIRE |
| ISSN: | 1546170X 10788956 |
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| DOI: | 10.1038/s41591-024-03019-1 |