Traumatic brain injury clinical score (TBICS) predicts survival outcomes in dogs and cats with acute traumatic brain injury

Objective: To describe the Traumatic Brain Injury Clinical Score (TBICS), assess its prognostic accuracy in dogs and cats hospitalized with acute TBI, and compare its performance with the modified Glasgow Coma Scale (MGCS). Methods: Cases were identified at the Koret School of Veterinary Medicine Teaching Hospital retrospectively (from 2017 through 2019) and prospectively (from 2019 through 2020). Animals were included if injury occurred within the preceding 24 hours and TBICS could be calculated from the neurological examination recorded within 24 hours after injury. The outcomes were survival to hospital discharge and survival ≥ 6 months. Receiver operating characteristic curves were generated, and the areas under the curve (AUCs) were compared between the TBICS and MGCS. Results: Short-term survival rates were 65.8% in dogs (25 of 38) and 64.5% in cats (20 of 31). In dogs, TBICS AUCs were 0.846 (short term) and 0.892 (long term); a cutoff of ≤ 8 yielded sensitivity/specificity of 80%/69.2% and 90.5%/73.3%, respectively. The MGCS AUCs were 0.812 and 0.873 with a cutoff of ≥ 14 (sensitivity/specificity, 60.0%/92.3% and 66.7%/93.3%, respectively). In cats, TBICS AUCs were 0.861 and 0.929; a cutoff of ≤ 7 yielded sensitivity/specificity of 70%/81.8% and 71.4%/88.9%. The MGCS AUC was 0.775 for short-term survival (cutoff, ≥ 13; sensitivity/specificity, 80%/63.6%). Conclusions: TBICS demonstrated good predictive accuracy for short- and long-term survival in dogs and cats with TBI and produced slightly higher AUC values than the MGCS in this cohort. Clinical Relevance: TBICS is an effective clinical tool for evaluating prognosis that can be completed within minutes of admission.