Scatter plot of Body weight and age both labelled by OSTA undex.

<p>The scatter plot displayed no significant correlation between body weight and age in our study cohort. (Pearson’s r = -0.064, <i>p</i> = 0.515). The size of the symbol indicates the OSTA value.</p

Independent factors for secondary outcome (complications) in the multivariate analyses.

<p>*Adjusted for gender, age, body weight, OSTA index, GCS, ISS, NISS, AIS-H and exposure of neurosurgery.</p><p>Independent factors for secondary outcome (complications) in the multivariate analyses.</p

Osteoporosis Self-Assessment Tool for Asians Can Predict Neurologic Prognosis in Patients with Isolated Moderate Traumatic Brain Injury

<div><p>Objectives</p><p>Osteoporosis Self-Assessment Tool for Asians (OSTA) has been proved to be a simple and effective tool for recognizing osteoporosis risk. Our previous study has demonstrated that the preoperative OSTA index was a good prognostic predictor for stage II and III colon cancer patients after surgery. We aim to evaluate the value of OSTA index in prognostication of isolated traumatic brain injury with moderate severity (GCS 9-13).</p><p>Methods</p><p>We retrospectively reviewed all patients visiting Kaohsiung Medical University Hospital emergency department due to isolated moderate traumatic brain injury from Jan. 2010 to Dec. 2012. Background data (including the OSTA index), clinical presentations, management and outcomes (ICU admission days, total admission days, complications, Glasgow outcome score (GOS) at discharge, mortality) of the patients were recorded for further analysis. Our major outcome was good neurologic recovery defined as GOS of 5. Pearson chi-square test and the Mann-Whitney U test were used to compare demographic features. Multiple logistic regression was used to identify independent risk factors.</p><p>Results</p><p>107 isolated moderate TBI patients were studied. 40 patients (37.4%) showed good recovery and 10 (9.3%) died at discharge. The univariate analysis revealed that younger age, higher OSTA index, lower ISS, lower AIS-H, and avoidance to neurosurgery were associated with better neurologic outcome for all moderate TBI patients. Multivariate analysis revealed that lower ISS, higher OSTA, and the avoidance of neurosurgery were independent risk factors predicting good neurologic recovery.</p><p>Conclusion</p><p>Higher ISS, lower OSTA index and exposure to neurosurgery were the independent risk factors for poorer recovery from isolated moderate TBI. In addition to labeling the cohort harboring osteoporotic risk, OSTA index could predict neurologic prognosis in patients with isolated moderate traumatic brain injury.</p></div

Univariate analysis regarding demographic and clinical characteristics in GOS-5 and GOS 1–4 groups.

<p>*The gender and receiving neurosurgery variables were tested by Chi-square test, the OSTA variable was tested by student-<i>t</i> test, and the other variables were tested by Mann-Whitney U test.</p><p>Univariate analysis regarding demographic and clinical characteristics in GOS-5 and GOS 1–4 groups.</p

Diagnostic performance of the OSTA index for good neurologic recovery (GOS = 5) in the study cohort.

<p>Receiver Operating Characteristic (ROC) curve shows an area of 0.734 (95% CI 0.638–0.831).</p

The ROC curve for the OSTA index predicting good neurologic recovery in the younger group (age<40).

<p>ROC curve of OSTA index with respect to detecting younger patient with GOS 5 with an AUC of 0.582.</p

The ROC curves comparing the proposed models and the OSTA index to predict good neurologic recovery in the study cohort.

<p>The discriminative performance of model B (ISS, OSTA index, and exposure to neurosurgery) is superior to model A (ISS and OSTA index) and OSTA index alone.</p

The ROC curve for the OSTA index predicting good neurologic recovery in the older group (age≧40).

<p>ROC curve of OSTA index with respect to detecting GOS 1–4 with an AUC of 0.719.</p

Independent factors for primary outcome in the multivariate analyses regarding different study cohorts.

<p>*Adjusted for gender, age, body weight, OSTA index, GCS, ISS, NISS, AIS-H and exposure of neurosurgery.</p><p>Independent factors for primary outcome in the multivariate analyses regarding different study cohorts.</p

Algorithm for study case selection.

<p>Algorithm for study case selection.</p