Table 2.
Adjusteda ordinal logistic regression analyses with GOSE scoreb as response variable and different TAI or contusion variables on MRI as explanatory variables
| All TBI | Severe TBI | Moderate TBI | Mild TBIc | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| (n = 452) | GCS score ≤ 8 (n = 176) | GCS score 9–12 (n = 74) | GCS score 13 (n = 55) | GCS 14–15 (n = 147) | |||||||||
| Location of TAI | n (%) | OR (95% CI) | p-value | n (%) | OR (95% CI) | p-value | n (%) | OR (95% CI) | p-value | n (%) | OR (95% CI) | p-value | n (%) |
| Bilateral TAI in brainstem/thalami | 43 (10) | 8.12 (4.32, 15.3) | < 0.001 | 40 (23) | 5.58 (2.80, 11.2) | < 0.001 | 3 (4) | NA | 0 | NA | 0 | ||
| Bilateral TAI in pons | 13 (3) | 11.7 (4.07; 33.4) | < 0.001 | 12 (7) | 10.7 (3.46; 33.2) | < 0.001 | 1 (1) | NA | 0 | NA | 0 | ||
| Bilateral TAI in mesencephalon/thalami | 30 (7) | 5.01 (2.49; 10.1) | < 0.001 | 28 (16) | 3.82 (1.77; 8.27) | 0.001 | 2 (3) | NA | 0 | NA | 0 | ||
| Any TAI in brainstem/thalami/basal gangliad | 128 (28) | 3.82 (2.49; 5.87) | < 0.001 | 94 (53) | 3.14 (1.78; 5.53) | < 0.001 | 22 (30) | 2.91 (1.03; 8.28) | 0.045 | 12 (22) | 0.65 (0.14; 3.16) | 0.59 | 0 |
| Bilateral TAI in brainstemd | 32 (7) | 10.3 (4.96; 21.2) | < 0.001 | 29 (16) | 6.01 (2.71; 13.3) | < 0.001 | 3 (4) | NA | 0 | NA | 0 | ||
| Unilateral TAI in brainstem | 52 (12) | 2.53 (1.44; 4.41) | 0.001 | 40 (23) | 1.30 (0.67; 2.54) | 0.44 | 10 (14) | 2.11 (0.50; 8.93) | 0.31 | 2 (4) | NA | 0 | |
| Bilateral TAI in thalamid | 19 (4) | 10.2 (4.18; 24.5) | < 0.001 | 19 (11) | 8.24 (3.17; 21.4) | < 0.001 | 0 | NA | 0 | NA | 0 | ||
| Unilateral TAI in thalamus | 42 (9) | 3.25 (1.73; 6.13) | < 0.001 | 31 (15) | 3.09 (1.44; 6.62) | 0.005 | 6 (8) | NA | 5 (9) | NA | 0 | ||
| Bilateral TAI in basal gangliad | 16 (4) | 7.93 (3.87; 20.6) | < 0.001 | 15 (9) | 5.42 (1.95; 15.0) | 0.001 | 1 | NA | 0 | NA | 0 | ||
| Unilateral TAI in basal ganglia | 43 (10) | 1.82 (0.98; 3.37) | 0.058 | 26 (15) | 2.72 (1.22; 6.06) | 0.015 | 8 (11) | NA | 9 (16) | NA | 0 | ||
| TAI in corpus callosumd | 143 (32) | 2.77 (1.82; 4.23) | < 0.001 | 107 (61) | 2.45 (1.38; 4.34) | 0.002 | 21 (28) | 0.78 (0.27; 2.24) | 0.65 | 14 (25) | 0.61 (0.13; 2.90) | 0.53 | 1 (1) |
| TAI in hemispheres | 252 (56) | 0.85 (0.52; 1.41) | 0.53 | 155 (88) | 0.63 (0.26; 1.51) | 0.30 | 54 (73) | 0.88 (0.34; 2.32) | 0.81 | 34 (62) | 1.14 (0.31; 4.17) | 0.84 | 9 (6) |
| TAI volumes or numbers | |||||||||||||
| Vol. TAI on FLAIR | 227 (50) | 1.78 (1.51; 2.10) | < 0.001 | 146 (83) | 2.04 (1.65; 2.52) | < 0.001 | 50 (68) | 1.42 (0.95; 2.11) | 0.089 | 25 (45) | 0.72 (0.31; 1.68) | 0.45 | 6 (4) |
| Vol. TAI on DWI | 176 (39) | 1.87 (1.52; 2.30) | < 0.001 | 112 (64) | 2.17 (1.66; 2.86) | < 0.001 | 40 (54) | 1.14 (0.63; 2.04) | 0.67 | 20 (36) | 0.95 (0.46; 1.97) | 0.89 | 4 (3) |
| No. TAI on T2*GRE/SWI | 240 (53) | 1.01 (1.01; 1.02) | < 0.001 | 149 (85) | 1.01 (1.00; 1.02) | 0.001 | 49 (66) | 1.00 (0.98; 1.02) | 0.86 | 33 (60) | 0.99 (0.96; 1.02) | 0.43 | 9 (6) |
| Contusions | |||||||||||||
| Contusions on CT | 152 (34) | 4.56 (3.16; 6.59) | < 0.001 | 90 (51) | 1.43 (0.84; 2.44) | 0.18 | 27 (36) | 2.19 (0.88; 5.46) | 0.092 | 30 (55) | 9.13 (2.19; 38.0) | 0.002 | 5 (3) |
| Contusions on MRI | 236 (52) | 7.42 (5.09; 10.8) | < 0.001 | 140 (80) | 2.37 (1.24; 4.54) | 0.009 | 50 (68) | 1.66 (0.63; 4.36) | 0.30 | 39 (71) | 3.02 (0.53; 17.3) | 0.22 | 7 (4) |
| Vol. contusions on MRI | 236 (52) | 1.36 (1.19; 1.55) | < 0.001 | 140 (80) | 1.33 (1.13; 1.57) | 0.001 | 50 (68) | 1.63 (1.12; 2.37) | 0.011 | 39 (71) | 2.34 (1.21; 4.51) | 0.011 | 7 (4) |
All volume variables were in cm3 and transformed to their natural logarithms and for these analyses also a presence variable was included (since the natural logarithm of zero does not exist). Significant values, p < 0.01, are in bold
GOSE Glasgow Outcome Scale Extended, TAI traumatic axonal injury, TBI traumatic brain injury, GCS Glasgow Coma Scale, n numbers, OR odds ratio, CI confidence interval, Vol. volume, No. numbers, FLAIR fluid-attenuated inversion recovery, DWI diffusion-weighted imaging, T2*GRE/SWI T2* gradient echo or susceptibility-weighted imaging, NA not applicable (indicated if n < 10)
a All analyses were adjusted for age and all analyses involving TAI variables for worst Marshall CT score
b Ordinal logistic regression analyses with inverted 6 months GOSE score as the response variable for severe TBI and moderate TBI with GCS score 9–12. Binary logistic regression predicting disability (GOSE score ≤ 6) at 6 months for moderate TBI with GCS score 13. For all TBI, ordinal logistic regression analyses with inverted 6 months (moderate-severe TBI) or 3 months (mild TBI) GOSE scores
c Due to low n (n < 10) for all MRI variables in the mild group, statistical analyses were not performed
d Can also include patients with bilateral TAI in the brainstem and/or thalami