Prediction of In-Hospital Mortality in Patients With Traumatic Brain Injury Using the Rotterdam and Marshall CT Scores: A Retrospective Study From Western India

被引:4
作者
Goswami, Brijesh [1 ]
Nanda, Vivek [2 ]
Kataria, Sharvilkumar [3 ]
Kataria, Deeti [4 ]
机构
[1] Apex Emergency Hosp, Dept Emergency Med, Ahmadabad, India
[2] Kusum Dhirajlal KD Hosp, Dept Emergency Med, Ahmadabad, India
[3] Siddhi Heart & Med Hosp, Dept Med, Ahmadabad, India
[4] Marengo Care Inst Med Sci CIMS Hosp, Dept Med, Ahmadabad, India
关键词
road travel accident; india; marshall ct score; in-hospital mortality; rotterdam ct score; traumatic brain injury;
D O I
10.7759/cureus.41548
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective Head trauma of any severity, including concussions and skull fractures, can cause a traumatic brain injury (TBI). Prognostication plays a vital role in the scenario of urgency put forth by TBI. The application of CT based scoring systems developed by the Rotterdam CT score and Marshall classification system appears to be appropriate for the early and precise prediction of clinical outcomes in TBI patients. The present study was designed to determine the predictive value of the Rotterdam CT score and Marshall classification system for in-hospital mortality in patients with TBI. Methods All adult patients (& GE; 18 years) with acute traumatic brain injury presented over a period from February 2019 to November 2022 were included. Only those patients who had undergone a plain CT scan of the brain during the initial presentation at the emergency department (ED) were considered. Patients who presented with penetrating brain injury as well as those who died on arrival or who died prior to the initial CT scan of the brain were excluded. A total of 127 patients were included in the final data analysis. Based on initial CT-scan findings, the Rotterdam CT score and Marshall classification system were calculated in order to predict in hospital mortality. Results The study was dominated by male patients (85.8%) as compared to female patients (14.2%). The overall mortality rate was 32.3% (n = 41). The mortality rate among males and females was 30.3% (33/109) and 44.4% (8/18), respectively. As per the Glasgow Coma Scale (GCS) classification, the severity of the injury was mild in 12.6% of the study subjects, moderate in 22%, and severe in 65.4%. The mortality rate among the patients with mild severity was 12.5% (2/16), while it was 28.6% in moderate (8/28) and 37.3% (31/83) in the severe category group. The best cut-off point of the Rotterdam score for predicting mortality was >4 (as per the Youden Index), which had a sensitivity and specificity of 60.98% and 90.70%, respectively, while the cutoff point of the Marshall CT classification for predicting mortality was >3 (as per the Youden Index), which had a sensitivity of 82.93% and a specificity of 75.58%. There was only a minor difference in the area under the curve (AUC) value of the receiver operating characteristic curve (ROC) curve between the Rotterdam CT score (0.827) and the Marshall classification system (0.833). Conclusion The Rotterdam and Marshall CT scores have demonstrated significant independent prognostic value and may serve as a useful initial evaluation tool for risk stratification of in-hospital mortality among patients with TBI.
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页数:9
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共 16 条
  • [1] Rotterdam and Marshall Scores for Prediction of in-hospital Mortality in Patients with Traumatic Brain Injury: An observational study
    Asim, Mohammad
    El-Menyar, Ayman
    Parchani, Ashok
    Nabir, Syed
    Ahmed, Mohamed Nadeem
    Ahmed, Zahoor
    Ramzee, Ahmed Faidh
    Al-Thani, Abdulaziz
    Al-Abdulmalek, Abdulrahman
    Al-Thani, Hassan
    [J]. BRAIN INJURY, 2021, 35 (07) : 803 - 811
  • [2] Prognosis of traumatic head injury in South Tunisia: A multivariate analysis of 437 cases
    Bahloul, M
    Chelly, H
    Ben Hmida, M
    Ben Hamida, C
    Ksibi, H
    Kallel, H
    Chaari, A
    Kassis, M
    Rekik, N
    Bouaziz, M
    [J]. JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE, 2004, 57 (02): : 255 - 261
  • [3] Dynamics of brain tissue changes induced by traumatic brain injury assessed with the Marshall, Morris-Marshall, and the Rotterdam classifications and its impact on outcome in a prostacyclin placebo-controlled study
    Bobinski, Lukas
    Olivecrona, Magnus
    Koskinen, Lars-Owe D.
    [J]. ACTA NEUROCHIRURGICA, 2012, 154 (06) : 1069 - 1079
  • [4] Charry JD, 2017, J NEUROSCI RURAL PRA, V8, P23, DOI 10.4103/jnrp.jnrp_434_16
  • [5] In-hospital mortality and the Glasgow Coma Scale in the first 72 hours after traumatic brain injury
    Costanti Settervall, Cristina Helena
    Cardoso de Sousa, Regina Marcia
    Fuerbringer e Silva, Silvia Cristina
    [J]. REVISTA LATINO-AMERICANA DE ENFERMAGEM, 2011, 19 (06): : 1337 - 1343
  • [6] Comparison of predictability of Marshall and Rotterdam CT scan scoring system in determining early mortality after traumatic brain injury
    Deepika, Akhil
    Prabhuraj, A. R.
    Saikia, Amrit
    Shukla, Dhaval
    [J]. ACTA NEUROCHIRURGICA, 2015, 157 (11) : 2033 - 2038
  • [7] Feigin VL, 2019, LANCET NEUROL, V18, P459, DOI [10.1016/S1474-4422(18)30415-0, 10.1016/S1474-4422(18)30499-X, 10.1016/S1474-4422(19)30034-1]
  • [8] Traumatic Brain Injury: Current Treatment Strategies and Future Endeavors
    Galgano, Michael
    Toshkezi, Gentian
    Qiu, Xuecheng
    Russell, Thomas
    Chin, Lawrence
    Zhao, Li-Ru
    [J]. CELL TRANSPLANTATION, 2017, 26 (07) : 1118 - 1130
  • [9] Epidemiology of traumatic brain injuries: Indian scenario
    Gururaj, G
    [J]. NEUROLOGICAL RESEARCH, 2002, 24 (01) : 24 - 28
  • [10] Helmy TA, 2015, AM J RES COMM, V3, P69