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The Mayo Classification System for Traumatic Brain Injury Severity
Abstract
PURPOSE: To develop a single TBI severity classification system based on commonly used TBI severity measures and indicators that (1) maximally uses available positive evidence to classify TBI severity in three categories: (a) Moderate-Severe (Definite) TBI, (b) Mild (Probable) TBI, (c) Symptomatic (Possible) TBI; (2) reflects current clinical knowledge and relevance; and (3) classifies a larger number of cases than single indicator systems with reasonable accuracy. MAIN FINDINGS: The study sample of a defined population consisted of 1501 unique Olmsted County residents with at least one confirmed TBI event from 1985 to 1999. Within the sample, 1678 TBI events were confirmed. Single measures of TBI severity were not available in a large percentage of these events, i.e., Glasgow Coma Scale (GCS) was absent in 1242 (74.0%); loss of consciousness, absent in 178 (70.2%), posttraumatic amnesia (PTA), absent in 974 (58.1%), head CT, not done in 827 (49.3%). The Mayo Classification System for TBI Severity was developed to classify cases based on available indicators that included death due to TBI, trauma-related neuroimaging abnormalities, GCS, PTA, loss of consciousness and specified post-concussive symptoms. Using the Mayo system, all cases were classified. For the Moderate-Severe (Definite) TBI classification, estimated sensitivity was 89% and estimated specificity was 98%. CONCLUSIONS: By maximally using relevant available positive evidence, the Mayo system classifies a larger number of cases than single indicator systems with reasonable accuracy. This system may be of use in retrospective research and for determination of TBI severity for planning postacute clinical care.
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“This classification system uses the strength of all positive evidence in the health record, allowing for TBI events to be diagnosed more accurately than from single indicator systems (eg, length of posttraumatic amnesia, initial Glasgow Coma Score, length of loss of consciousness).34,35”
From Long-Term Risk for Mood and Anxiety Disorders After Pediatric Traumatic Brain Injury: A Population-Based, Birth Cohort Analysis (2023) · cites this paper as [34]
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The American Congress of Rehabilitation Medicine Diagnostic Criteria for Mild Traumatic Brain Injury
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“Loss of, and alterations to, consciousness, were widespread, suggesting at least mild brain injury per the Mayo classification system (Malec et al., 2007).”
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Relationships between alexithymia, affect recognition, and empathy after traumatic brain injury
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Self-citationLoBue, C., Munro, C., Schaffert, J., Didehbani, N., Hart, Batjer, H., & Cullum, C. M. (2019) · Journal of Alzheimer's Disease · doi:10.3233/jad-190028 · Cited by 86
Pituitary dysfunction after blast traumatic brain injury: The UK BIOSAP study
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Cognitive and Behavioral Outcomes from Traumatic Brain Injury
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Increased Risk of Stroke Among Young Adults With Serious Traumatic Brain Injury
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Mental and Physical Health Comorbidities in Traumatic Brain Injury: A Non-TBI Controls Comparison
Ayton, A., Spitz, G., Hicks, A. J., & Ponsford, J. (2024) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2024.03.005 · Cited by 11
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Self-citation
Metadata
- Authors
- Malec, J. F., Brown, A. W., Leibson, C. L., Flaada, J. T., Mandrekar, J. N., Diehl, N. N., & Perkins, P. K.
- Venue
- Journal of Neurotrauma
- Publisher
- SAGE Publications
- Published
- 2007-09
- Volume
- 24
- Issue
- 9
- Pages
- 1417-1424
- ISSN
- 0897-7151 (ISSN-L)
- 1557-9042
- OpenAlex
- W2100240119
- Cited by
- 669
- References
- 7
- FWCI
- 4.19
- Type
- journal article
- Language
- en
- Open access
- closed
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