{"id":"39711718-3175-41e1-8826-1e0d3e3ffdad","slug":"an-external-validation-of-clinical-based-score-to-predict-traumatic-intracranial-hemorrhage-on-computed-tomography-scan-and-surgical-intervention-in-mild-traumatic-brain-injury-patients","title":"An external validation of clinical-based score to predict traumatic intracranial hemorrhage on computed tomography scan and surgical intervention in mild traumatic brain injury patients","authors":["Tanat Vaniyapong","Jayanthon Patumanond","Sanguansin Ratanalert","Kriengsak Limpastan"],"abstract":"Background: Prediction rules for computed tomography (CT) use in mild traumatic brain injury (MTBI) often have limited generalizability due to restrictive inclusion criteria and development in high-income countries. A clinical-based prediction score was recently developed for a broader MTBI population in a low- to middle-income country. This study aims to externally validate this score in a new patient dataset. Methods: We prospectively collected data from adult patients with MTBI (Glasgow Coma Scale score 13–15) presenting to a hospital in Thailand between 2014 and 2016. The performance of the 13-predictor clinical-based score was evaluated for two outcomes: traumatic intracranial findings on CT and need for neurosurgical intervention. We assessed discrimination using the area under the receiver operating characteristic curve (AuROC) and diagnostic accuracy at predetermined cut-points. Results: The study included 565 patients. Seventy-two patients (12.7%) had a positive CT scan, and 8 (1.4%) required neurosurgical intervention. The AuROC was 0.70 for predicting a positive CT scan and 0.78 for predicting neurosurgical intervention. At a cut-point score of ≥2, the sensitivity for a positive CT was 97.2% with a specificity of 12.6%. At a cut-point score of ≥3, the sensitivity for neurosurgical intervention was 100% with a specificity of 21.0%. Conclusion: The clinical prediction score demonstrated acceptable and safe diagnostic performance in an external validation cohort, maintaining high sensitivity for critical outcomes. The score may be a useful tool to help guide management policy for MTBI patients, particularly in low- to middle-income countries.","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/39711718-3175-41e1-8826-1e0d3e3ffdad/featured/hero-1781558019534.png","publishDate":"2026-01-09T00:00:00.000Z","doi":"10.25259/SNI_763_2024","categories":["Trauma","Original Article"],"fullTextUrl":"https://surgicalneurologyint.com/api/articles/39711718-3175-41e1-8826-1e0d3e3ffdad/pdf"}