External validation of the rotterdam computed tomography score in the prediction of mortality in severe traumatic brain injury

Abstract

Introduction:Traumatic brain injury (TBI) is a public health problem. It is a pathology that causes significant mortality and disability in Colombia. Different calculators and prognostic models have been developed to predict the neurological outcomes of these patients. The Rotterdam computed tomography (CT) score was developed for prognostic purposes in TBI. We aimed to examine the accuracy of the prognostic discrimination and prediction of mortality of the Rotterdam CT score in a cohort of trauma patients with severe TBI in a university hospital in Colombia.Materials and Methods:We analyzed 127 patients with severe TBI treated in a regional trauma center in Colombia over a 2-year period. Bivariate and multivariate analyses were used. The discriminatory power of the score, its accuracy, and precision were assessed by logistic regression and as the area under the receiver operating characteristic curve. Shapiro–Wilk, Chi-square, and Wilcoxon tests were used to compare the real outcomes in the cohort against the predicted outcomes.Results:The median age of the patient cohort was 33 years, and 84.25% were male. The median injury severity score was 25, the median Glasgow Coma Scale motor score was 3, the basal cisterns were closed in 46.46% of the patients, and a midline shift of >5 mm was seen in 50.39%. The 6-month mortality was 29.13%, and the Rotterdam CT score predicted a mortality of 26% (P < 0.0001) (area under the curve: 0.825; 95% confidence interval: 0.745–0.903).Conclusions:The Rotterdam CT score predicted mortality at 6 months in patients with severe head trauma in a university hospital in Colombia. The Rotterdam CT score is useful for predicting early death and the prognosis of patients with TBI.

Predictive Value of Rotterdam Score and Marshall Score in Traumatic Brain Injury: A Contemporary Review

“…7 9 10 Recently, many studies were conducted to evaluate the comparative efficacy of the two prediction models. 5 7 11 12 13 14 Each of these models aims at improving the outcome prediction and has their own sets of limitations. Since guidelines for surgery in TBI patients is not uniform worldwide, two major limitations of Marshall scoring is stated as the division of hematoma based on volume and surgical evacuation.…”

Rationalising neurosurgical head injury referrals: development and validation of the Liverpool Head Injury Tomography Score (Liverpool HITS) for mild TBI

“…This is the first scoring system of its kind to the authors' knowledge. There are CT based scoring systems that accurately predict TBI mortality (such as Marshall and Rotterdam scores) [34][35][36] however none of these are specific to mild TBI, nor do they reference referral criteria for being accepted to a neurosurgical unit 37 . This means the potential impact on practice is high, as there is no current way of deciphering a surgically significant mild TBI at the level of national guidance.…”

The role of Diffusion-Weighted Imaging in better delineating the extent of Diffuse Axonal Injury in a pediatric patient: A case report and brief review of the literature

“…The degree of basal cistern compression, the midline shift, the presence of epidural hematomas and the presence of SAH or intraventricular hemorrhage. Higher scores are associated with an increased probability of an unfavorable outcome [12].…”