Evidence map›Paper›PMID 41507677›Full record

ArticleNeurocritical care2026

Trajectories of daily inpatient blood biomarkers of physiological function improve mortality and morbidity prognostic model performance for patients with severe traumatic brain injury.

Shawn R Eagle, Regan Shanahan, Jaeyong Shim, Mark A MacLean, Anna Slingerland, Shovan Bhatia, Michael R Kann, Tyler Augi, Ava Puccio, David O Okonkwo

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Article in Neurocritical care, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

10 authors.

Shawn R EagleDepartment of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA, USA. eaglesr2@upmc.edu.ORCID 0000-0001-6767-1042
Regan ShanahanDepartment of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
Jaeyong ShimCarnegie Mellon University, Pittsburgh, PA, USA.
Mark A MacLeanDivision of Neurosurgery, Dalhousie University, Halifax, NS, Canada.
Anna SlingerlandDepartment of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
Shovan BhatiaDepartment of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
Michael R KannDepartment of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
Tyler AugiDepartment of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
Ava PuccioDepartment of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA, USA.
David O OkonkwoDepartment of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundWe sought to assess the prognostic value of incorporating daily inpatient physiological biomarker trajectories to the International Mission for Prognosis and Analysis of Clinical Trials in TBI (IMPACT) model for mortality and morbidity six months after severe traumatic brain injury (TBI).

methodsPatients with severe TBI (presenting Glasgow Coma Scale ≤ 8) were prospectively collected in a single-center database (n = 598). Morbidity (yes/no) was defined as Glasgow Outcome Scale Extended of 1-4. Daily blood labs (e.g., glucose, sodium, platelets, hemoglobin, neutrophils, lymphocytes, creatinine, blood urea nitrogen) were extracted for the first 14 days after injury. IMPACT was compared with IMPACT-extended (IMPACT + daily lab trajectories) for area under the curve (AUC). Net reclassification index (NRI) assessed the number of correctly reclassified cases for IMPACT-extended compared with IMPACT.

resultsIMPACT-extended had a better AUC than IMPACT for mortality (AUC 0.93 vs. 0.84, P < 0.001) and morbidity (AUC 0.84 vs. 0.80, P < 0.001). NRI analyses revealed IMPACT-extended improved correct classifications of patients who survived to 6 months by 41%. NRI analyses revealed that IMPACT-extended modestly improved correct classification of controls by 4% compared with IMPACT.

conclusionsIncorporating trajectories for daily blood biomarkers of physiological function significantly improves the discrimination and clinically relevant performance of existing prognostic models for both morbidity and mortality six months following severe TBI.

Indexed as

BiomarkersBrain Injuries, TraumaticAdultClinical RelevanceFemaleHumansMaleMiddle AgedModels, TheoreticalMorbidityOutcome Assessment, Health CarePrognosisRetrospective StudiesBiomarkersBiomarkersIMPACTPrognostic modelsSevere TBI

Identifiers

PMID41507677

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.