A mathematical model to predict, with 85% accuracy, the clinical outcomes of the recovery from the coma of patients with severe brain injuries. It is the result of research coordinated by the Institute for Biomedical Research and Innovation of the National Research Council of Messina (Cnr-Irib) and by the Institute of Systems Analysis and Informatics of the National Research Council of Rome (Cnr -Iasi), created thanks to the data collected from a study conducted by the Sant’Anna Institute of Crotone and other national clinical centres. The research, published in Scientific Reports, examined the data of 156 patients with severe acquired brain injury, i.e. extensive damage to the brain of traumatic or vascular origin, such as to determine a state of coma that can last for short or long periods of time.
The study made it possible to create the model and predict the ‘trajectories’ of clinical outcomes for each individual patient. “In the cases of people suffering from serious acquired brain injuries – explains Francesca Lucia Lucca, primary doctor of the Awakening Unit of the S’Anna Institute of Crotone – although there are some internationally accepted clinical parameters that indicate what the probability of recovery of consciousness may be , it is currently not possible to know exactly what the clinical course will be for each individual patient: hospital admissions, both for resuscitation or neurosurgical operations, and for subsequent rehabilitative operations, can last for weeks or months”.
“The patients studied were hospitalized in intensive rehabilitation facilities distributed throughout the country: of these, most had vascular damage (50.6%), followed by traumatic pathologies (36%) and anoxia ( 9.6%). For each, data relating to the clinical condition at the time of admission to rehabilitation and during the entire period of hospitalization up to their discharge were collected: on discharge, approximately 3% had died, 61% had a complete recovery of consciousness, while 36% remained in a vegetative or minimally conscious state”.
It was precisely the analysis of the clinical condition along the entire time interval of hospitalization that made it possible to create the evolution model using a mathematical equation. “For the first time, the evolution trajectories of the patients’ state of consciousness have been characterized from a mathematical point of view, predicting the recovery of the patients’ brain functions or, in the worst cases, the degree of disability”, adds Simona Panunzi, researcher of the Cnr-Iasi.
The methodological approach used made it possible to identify a series of variables which, summarized in a descriptive index of the subject’s state of consciousness, made it possible to predict the clinical outcome of the patients with an accuracy of 85%. “The interesting fact is that, three months after hospitalisation, the outcome of patients with a positive outcome clearly differed from those with a negative outcome”, concludes Antonio Cerasa, a researcher at the Cnr-Irib. “Having a greater amount of data recorded throughout the clinical course of patients admitted to neurorehabilitation centers available, we could soon provide a useful computational system to support medical personnel, with continuously updated information on how current treatments can divert trajectories of clinical outcomes”.
