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This multicenter study developed and externally validated a machine-learning model to estimate individualized benefit from cranial surgery in severe TBI. Among 10,782 TQIP patients, 23% underwent surgery. The model showed strong discrimination for favorable discharge (AUC 0.845) and mortality (AUC 0.890). Simulated use increased favorable discharge by 4.1% and reduced mortality by 13.1%. In 182 external-validation patients, improvements were 10.6% and 43.4%, respectively.
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This multicenter study developed and externally validated a machine-learning model to estimate individualized benefit from cranial surgery in severe TBI. Among 10,782 TQIP patients, 23% underwent surgery. The model showed strong discrimination for favorable discharge (AUC 0.845) and mortality (AUC 0.890). Simulated use increased favorable discharge by 4.1% and reduced mortality by 13.1%. In 182 external-validation patients, improvements were 10.6% and 43.4%, respectively.
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