A2 Review article in a scientific journal

Assessing the Severity of Traumatic Brain Injury-Time for a Change?

List of Authors: Tenovuo Olli, Diaz-Arrastia Ramon, Goldstein Lee E, Sharp David J, van der Naalt Joukje, Zasler Nathan D

Publisher: MDPI

Publication year: 2021

Journal: Journal of Clinical Medicine

Journal name in source: JOURNAL OF CLINICAL MEDICINE

Journal acronym: J CLIN MED

Volume number: 10

Issue number: 1

Number of pages: 12

eISSN: 2077-0383

DOI: http://dx.doi.org/10.3390/jcm10010148

URL: https://www.mdpi.com/2077-0383/10/1/148

Traumatic brain injury (TBI) has been described to be man's most complex disease, in man's most complex organ. Despite this vast complexity, variability, and individuality, we still classify the severity of TBI based on non-specific, often unreliable, and pathophysiologically poorly understood measures. Current classifications are primarily based on clinical evaluations, which are non-specific and poorly predictive of long-term disability. Brain imaging results have also been used, yet there are multiple ways of doing brain imaging, at different timepoints in this very dynamic injury. Severity itself is a vague concept. All prediction models based on combining variables that can be assessed during the acute phase have reached only modest predictive values for later outcome. Yet, these early labels of severity often determine how the patient is treated by the healthcare system at large. This opinion paper examines the problems and provides caveats regarding the use of current severity labels and the many practical and scientific issues that arise from doing so. The objective of this paper is to show the causes and consequences of current practice and propose a new approach based on risk classification. A new approach based on multimodal quantifiable data (including imaging and biomarkers) and risk-labels would be of benefit both for the patients and for TBI clinical research and should be a priority for international efforts in the field.

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Last updated on 2021-24-06 at 08:09