ArticleNeurotrauma reports2023
Performance of CRASH and IMPACT Prognostic Models for Traumatic Brain Injury at 12 and 24 Months Post-Injury.
Article in Neurotrauma reports, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
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Who cites it
21 citing papers in PubMed.
- Extension of the FUNC Score for Prediction of 12-Month Functional Independence after Primary Intracerebral Hemorrhage.Neurocritical care · 2026Article
- Future Directions and Evolution Strategies for the Clinical Management of Traumatic Brain Injury.Journal of clinical medicine · 2026Article
- The Impact of Hemoglobin Transfusion Thresholds in Moderate-to-Severe Blunt Traumatic Brain Injury on 6-Month Neurologic Outcomes: A Systematic Review and Meta-Analysis.Neurology international · 2026Article
- To Do or Not to Do: Decompressive Craniectomy for Severe Traumatic Brain Injury.Asian journal of neurosurgery · 2026Review
- Early risk stratification in traumatic brain injury: An analysis of MEWS and rSIG scores in patients with isolated head trauma.Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES · 2026Observational
- The ethics of blood stewardship and quantitative futility assessments to predict certain death in neurotrauma patients.Frontiers in medicine · 2026Review
- Extracellular vesicles as biomarkers for traumatic brain injury using a 3D in vitro human brain tissue model.Scientific reports · 2025Article
- Predicting outcomes after moderate and severe traumatic brain injury using artificial intelligence: a systematic review.NPJ digital medicine · 2025Article
- Traumatic Brain Injury and Artificial Intelligence: Shaping the Future of Neurorehabilitation-A Review.Life (Basel, Switzerland) · 2025Review
- Machine Learning Approaches to Prognostication in Traumatic Brain Injury.Current neurology and neuroscience reports · 2025Review
- ASA score is an independent predictor of 1-year outcome after moderate-to-severe traumatic brain injury.Scandinavian journal of trauma, resuscitation and emergency medicine · 2025Article
- Early Prognostication in Pediatric Severe Traumatic Brain Injury in South America: Development of a Local Pediatric-Specific Model and Validation of Established Models.Neurotrauma reports · 2025Article
- Exploration of simultaneous transients between cerebral hemodynamics and the autonomic nervous system using windowed time-lagged cross-correlation matrices: a CENTER-TBI study.Acta neurochirurgica · 2024Article
- Automated Measurement of Cerebral Hemorrhagic Contusions and Outcomes After Traumatic Brain Injury in the TRACK-TBI Study.JAMA network open · 2024Article
- Traumatic Brain Injury as an Independent Predictor of Futility in the Early Resuscitation of Patients in Hemorrhagic Shock.Journal of clinical medicine · 2024Review
- Would You Rather: Quantifying Traumatic Brain Injury Survivor Perceptions of Functional Status Through Their Surrogates.Annals of surgery · 2024Article
- Insights into epileptogenesis from post-traumatic epilepsy.Nature reviews. Neurology · 2024Review
- Comparative analysis of CRASH and IMPACT in predicting the outcome of 340 patients with traumatic brain injury.Translational neuroscience · 2024Article
- Computational Prognostic Modeling in Traumatic Brain Injury.Advances in experimental medicine and biology · 2024Review
- Comparative Analysis of Clinical Severity and Outcomes in Penetrating Versus Blunt Traumatic Brain Injury Propensity Matched Cohorts.Neurotrauma reports · 2024Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
The Corticoid Randomization after Significant Head Injury (CRASH) and International Mission for Prognosis and Analysis of Clinical Trials (IMPACT) prognostic models are the most reported prognostic models for traumatic brain injury (TBI) in the scientific literature. However, these models were developed and validated to predict 6-month unfavorable outcome and mortality, and growing evidence supports continuous improvements in functional outcome after severe TBI up to 2 years post-injury. The purpose of this study was to evaluate CRASH and IMPACT model performance beyond 6 months post-injury to include 12 and 24 months post-injury. Discriminative validity remained consistent over time and comparable to earlier recovery time points (area under the curve = 0.77-0.83). Both models had poor fit for unfavorable outcomes, explaining less than one quarter of the variation in outcomes for severe TBI patients. The CRASH model had significant values for the Hosmer-Lemeshow test at 12 and 24 months, indicating poor model fit past the previous validation point. There is concern in the scientific literature that TBI prognostic models are being used by neurotrauma clinicians to support clinical decision making despite the goal of the models' development being to support research study design. The results of this study indicate that the CRASH and IMPACT models should not be used in routine clinical practice because of poor model fit that worsens over time and the large, unexplained variance in outcomes.
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