Improving the prediction of outcome in severe acute closed head injury by using discriminant function analysis of normal auditory brainstem response latencies and amplitudes

Wilson, WJ, Penn, C, Saffer, D and Aghdasi, F (2002) Improving the prediction of outcome in severe acute closed head injury by using discriminant function analysis of normal auditory brainstem response latencies and amplitudes. Journal of Neurosurgery, 97 5: 1062-1069. doi:10.3171/jns.2002.97.5.1062


Author Wilson, WJ
Penn, C
Saffer, D
Aghdasi, F
Title Improving the prediction of outcome in severe acute closed head injury by using discriminant function analysis of normal auditory brainstem response latencies and amplitudes
Journal name Journal of Neurosurgery   Check publisher's open access policy
ISSN 0022-3085
Publication date 2002-01-01
Sub-type Article (original research)
DOI 10.3171/jns.2002.97.5.1062
Volume 97
Issue 5
Start page 1062
End page 1069
Total pages 8
Place of publication Charlottesville
Publisher Amer Assoc Neurological Surgeons
Language eng
Abstract Object. The auditory brainstem response (ABR) is a useful addition to standard medical measures for predicting outcome in patients with severe acute closed head injury (ACHI). Limiting this success, however, is the poor predictive value of a so-called "normal" ABR. In this study the authors used discriminant function analysis (DFA) of ABR Wave I, III, and V latencies and amplitudes to improve the predictive accuracy of the normal ABR, both as a single measure and in combination with other standard medical measures. Methods. The DFAs were conducted using the ABR and medical results in 68 patients with severe ACHI (30 who died [ACHI-died], and 38 who survived [ACHI-lived]) who presented with normal ABR responses in the neurosurgical intensive care unit of the authors' hospital in Johannesburg. All patients had undergone surgery to remove an intracranial hematoma. Correct predictions of outcome by ABR DFA measures were 83% for the ACHI-died group (48% at greater than or equal to 90% confidence level) and 87% for the ACHI-lived group (71% at greater than or equal to 90% confidence level); by medical DFA measures the correct predictions were 83% for the ACHI-died group (96% at greater than or equal to 90% confidence level) and 95% for the ACHI-lived group (94% at greater than or equal to 90% confidence level); and by combined ABR and medical DFA measures correct predictions were 100% for the ACHI-died group (100% at greater than or equal to 90% confidence level) and 97% for the ACHI-lived group (100% at greater than or equal to 90% confidence level). Conclusions. The DFA of ABR Wave I, III, and V latencies and amplitudes improved the predictive ability of normal ABR results to rates similar to those obtained using DFA for the medical measures, although at lower confidence levels. The DFA of the combined ABR and medical measures improved correct predictions to rates significantly higher than for either of the measures on its own.
Keyword Clinical Neurology
Surgery
auditory brainstem response
discriminant function analysis
head injury
Multimodality-evoked-potentials
Intra-cranical Pressure
Prognostic Implications
Comatose Patients
Experience
Features
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Unknown

Document type: Journal Article
Sub-type: Article (original research)
Collections: Excellence in Research Australia (ERA) - Collection
School of Health and Rehabilitation Sciences Publications
 
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Created: Wed, 17 Oct 2007, 21:38:48 EST