Incorporating immunoproteins in the development of classification models of progression of intracranial hemorrhage after traumatic brain injury

H. E. Hinson, Peter Li, Loren Myers, Chinar Agarwal, Jeffrey Pollock, Shannon McWeeney

Research output: Contribution to journalArticlepeer-review


Objective: To define clinical, radiographic, and blood-based biomarker features to be incorporated into a classification model of progression of intracranial hemorrhage (PICH), and to provide a pilot assessment of those models. Methods: Patients with hemorrhage on admission head computed tomography were identified from a prospectively enrolled cohort of subjects with traumatic brain injury. Initial and follow-up images were interpreted both by 2 independent readers, and disagreements adjudicated. Admission plasma samples were analyzed and principal components (PCs) composed of the immune proteins (IPs) significantly associated with the outcome of interest were selected for further evaluation. A series of logistic regression models were constructed based on (1) clinical variables (CV) and (2) clinical variables + immune proteins (CV+IP). Error rates of these models for correct classification of PICH were estimated; significance was set at P < .05. Results: We identified 106 patients, 36% had PICH. Dichotomized admission Glasgow Coma Scale (P = .004), Marshall score (P = .004), and 3 PCs were significantly associated with PICH. For the CV only model, sensitivity was 1.0 and specificity was 0.29 (95% CI, 0.07-0.67). The CV+IP model performed significantly better, with a sensitivity of 0.93 (95% CI, 0.64-0.99) and a specificity of 1.0 (P = .008). Adjustments to refine the definition of PICH and better define radiographic predictors of PICH did not significantly improve themodels' performance. Conclusions: In this pilot investigation, we observed that composites of IPs may improve PICH classification models when combined with CVs. However, overall model performance must be further optimized; results will inform feature inclusion included in follow-up models.

Original languageEnglish (US)
Pages (from-to)E322-E328
JournalJournal of Head Trauma Rehabilitation
Issue number5
StatePublished - Sep 2021


  • Predictive modeling
  • Progression of intracranial hemorrhage
  • Progressive hemorrhagic injury
  • Traumatic brain injury
  • Traumatic intracranial hemorrhage

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation
  • Clinical Neurology


Dive into the research topics of 'Incorporating immunoproteins in the development of classification models of progression of intracranial hemorrhage after traumatic brain injury'. Together they form a unique fingerprint.

Cite this