{
  "abstract": "Background Traumatic cerebral venous sinus injuries (tCVSIs) are critical complications of traumatic brain injury (TBI) that can lead to intracranial hypertension, edema, and infarction. Current classification schemes rely primarily on radiologic features and lack predictive value for clinical outcomes. We sought to develop and validate a bedside scoring tool that incorporates vascular anatomy, fracture morphology, and systemic physiology to predict patients’ functional recovery.Methods This retrospective multicenter cohort analysis examined patients with radiographically confirmed tCVSI across three Level 1 trauma centers (2018-2024). A random forest ensemble model identified the global hierarchy of importance among candidate radiographic and clinical predictors available at presentation. Integer weights for a 10-point scale were derived from marginal risk magnitudes calculated via partial dependence plots. The primary outcome was favorable functional recovery at last follow-up (extended Glasgow Outcome Scale score ≥ 5).Results The 254-patient cohort had a mean age of 45.6 years and a mean admission GCS score of 10.2. Favorable outcomes were achieved in 73.9% of patients. The 10-point score achieved an area under the curve of 0.85 for prediction of clinical outcomes. At an optimal cutoff score of 4, the model achieved a sensitivity of 82% and a specificity of 74%. Predictive performance for 30-day mortality was more modest (area under the curve of 0.65).Conclusions The integrated tCVSI severity score is a novel tool with high fidelity for predicting functional recovery in patients with tCVSI. By integrating anatomical and physiological markers, this score provides a structured framework to guide clinical risk-benefit discussions and triage management strategies.Disclosures J. Brown: None. A. Ramesh: None. R. Abo Kasem: None. P. Bi: None. F. Hamrick: None. I. Abecassis: None. E. Sieg: None. S. Chen: None. R. Bonow: None. R. Grandhi: None.Abstract P-020 Figure 1Abstract P-020 Table 1Final tCVSI severity score",
  "authors": [
    {
      "affiliations": [
        "University of Utah, Salt Lake City, UT"
      ],
      "name": "J Brown"
    },
    {
      "affiliations": [
        "University of California Irvine, Irvine, CA"
      ],
      "name": "A Ramesh"
    },
    {
      "affiliations": [
        "Neurological Surgery, University of Louisville, Louisville, KY"
      ],
      "name": "R Abo Kasem"
    },
    {
      "affiliations": [
        "Neurological Surgery, University of Washington, Seattle, WA"
      ],
      "name": "D Nistal"
    },
    {
      "affiliations": [
        "School of Medicine, University of Washington, Seattle, WA"
      ],
      "name": "P Bi"
    },
    {
      "affiliations": [
        "Neurosurgery, University of Utah, Salt Lake City, UT"
      ],
      "name": "F Hamrick"
    },
    {
      "affiliations": [
        "Neurological Surgery, University of Louisville, Louisville, KY"
      ],
      "name": "I Abecassis"
    },
    {
      "affiliations": [
        "Neurological Surgery, University of Louisville, Louisville, KY"
      ],
      "name": "E Sieg"
    },
    {
      "affiliations": [
        "Neurological Surgery, University of Washington, Seattle, WA"
      ],
      "name": "S Chen"
    },
    {
      "affiliations": [
        "Neurological Surgery, University of Washington, Seattle, WA"
      ],
      "name": "R Bonow"
    },
    {
      "affiliations": [
        "Neurosurgery, University of Utah, Salt Lake City, UT"
      ],
      "name": "R Grandhi"
    }
  ],
  "title": "P-020 Outcome prediction in traumatic cerebral venous sinus injury using new stratification system of injury severity",
  "uid": "84d6a2d2-22d7-548f-a28d-17150da8edf2"
}