Sistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSPVIEIRA, Rita de Cassia AlmeidaSILVEIRA, Juliana Cristina PereiraPAIVA, Wellingson SilvaOLIVEIRA, Daniel Vieira deSOUZA, Camila Pedroso Estevam deSANTANA-SANTOS, EduesleySOUSA, Regina Marcia Cardoso de2022-12-212022-12-212022NEUROCRITICAL CARE, v.37, n.3, p.790-805, 20221541-6933https://observatorio.fm.usp.br/handle/OPI/50814This review aimed to analyze the results of investigations that performed external validation or that compared prognostic models to identify the models and their variations that showed the best performance in predicting mortality, survival, and unfavorable outcome after severe traumatic brain injury. Pubmed, Embase, Scopus, Web of Science, Cumulative Index to Nursing and Allied Health Literature, Google Scholar, TROVE, and Open Grey databases were searched. A total of 1616 studies were identified and screened, and 15 studies were subsequently included for analysis after applying the selection criteria. The Corticosteroid Randomization After Significant Head Injury (CRASH) and International Mission for Prognosis and Analysis of Clinical Trials in Traumatic Brain Injury (IMPACT) models were the most externally validated among studies of severe traumatic brain injury. The results of the review showed that most publications encountered an area under the curve >= 0.70. The area under the curve meta-analysis showed similarity between the CRASH and IMPACT models and their variations for predicting mortality and unfavorable outcomes. Calibration results showed that the variations of CRASH and IMPACT models demonstrated adequate calibration in most studies for both outcomes, but without a clear indication of uncertainties in the evaluations of these models. Based on the results of this meta-analysis, the choice of prognostic models for clinical application may depend on the availability of predictors, characteristics of the population, and trauma care services.engrestrictedAccessBrain injuryOutcome assessmentPredictive modelingPrognostic modelingsevere head-injuryexternal validationinternational missionclinical-trialsprediction modelsimpact modelscrashmortalityrandomizationscorearticleCopyright HUMANA PRESS INC10.1007/s12028-022-01547-7Critical Care MedicineClinical Neurology1556-0961