{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T16:27:04Z","timestamp":1787761624258,"version":"build-2784847793"},"reference-count":25,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T00:00:00Z","timestamp":1787702400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Moderate-to-severe traumatic brain injury (msTBI) remains a leading cause of long-term disability and mortality. While multimodal neuromonitoring (MMM) provides real-time insights into cerebral pathophysiology, its integration into prognostic models for long-term outcomes requires further validation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To develop and evaluate a prognostic model for 6-month neurological outcomes in msTBI patients using acute-phase multimodal monitoring parameters, clinical variables, and comorbidities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We conducted a retrospective cohort study of 143 adult patients with msTBI [Glasgow Coma Scale (GCS) 4\u201312] who underwent multimodal intracranial monitoring (ICP, CPP, PbtO\u2082, and cerebral microdialysis) for \u226548\u202fh at\n                      <jats:italic>Hospital<\/jats:italic>\n                      between June 2022 and May 2025. Demographic, clinical, and monitoring data from the first 5\u202fdays were collected. The primary outcome was neurological function at 6\u202fmonths, assessed by the Glasgow Outcome Scale-Extended (GOSE), dichotomized as favorable (GOSE 5\u20138) or unfavorable (GOSE 1\u20134). Multivariable logistic regression was used to identify independent predictors, and a prognostic model was constructed and internally validated using ROC analysis and the Hosmer-Lemeshow test.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 143 patients, 86 (60.1%) had favorable outcomes and 57 (39.9%) had unfavorable outcomes (including 29 deaths). Independent predictors of unfavorable outcome were: older age (adjusted OR 1.055 per year, 95% CI: 1.015\u20131.098), lower admission GCS (OR 0.713, 95% CI: 0.537\u20130.947), elevated lactate\/pyruvate ratio (LPR) (OR 1.129 per unit, 95% CI: 1.044\u20131.220), reduced brain tissue oxygen tension (PbtO\u2082) (OR 0.842 per mmHg, 95% CI: 0.730\u20130.972), and pre-existing coronary heart disease (OR 3.866, 95% CI: 0.998\u201314.976). The final model demonstrated excellent discriminative performance with an AUC of 0.882 (95% CI: 0.820\u20130.944) and good calibration (Hosmer-Lemeshow\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.523). A dose\u2013response relationship was observed between the number of abnormal monitoring parameters and risk of poor outcome.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A prognostic model incorporating multimodal neuromonitoring parameters (LPR and PbtO\u2082), age, admission GCS, and coronary heart disease accurately predicts 6-month outcomes in msTBI patients. These findings support the clinical utility of integrated neuromonitoring for early risk stratification and personalized neurocritical care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2025.1708954","type":"journal-article","created":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T16:01:00Z","timestamp":1787760060000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["A prognostic model for long-term outcome in moderate-severe traumatic brain injury using multimodal neuromonitoring: a retrospective cohort analysis"],"prefix":"10.3389","volume":"16","author":[{"given":"Yang","family":"Li","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, The General Hospital of Western Theater Command","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kanglin","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The General Hospital of Western Theater Command","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"XiaoPing","family":"He","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The General Hospital of Western Theater Command","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yixin","family":"Lin","sequence":"additional","affiliation":[{"name":"Pu'er People's Hospital","place":["Pu'er, China"]},{"name":"Beijing Chaoyang Hospital Affiliated to Capital Medical University","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuan","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The General Hospital of Western Theater Command","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,26]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"357","DOI":"10.1186\/s13054-025-05604-3","article-title":"Impact of oxygen and carbon dioxide levels on mortality in moderate to severe traumatic brain injury: a systematic review and meta-analysis","volume":"29","author":"Atkin-Jones","year":"2025","journal-title":"Crit Care"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"769","DOI":"10.1007\/s12028-023-01771-9","article-title":"Hypertonic saline versus other intracranial-pressure-lowering agents for patients with acute traumatic brain injury: a systematic review and meta-analysis","volume":"40","author":"Bernhardt","year":"2024","journal-title":"Neurocrit Care"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"CD011725","DOI":"10.1002\/14651858.CD011725.pub2","article-title":"Indomethacin for intracranial hypertension 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