Outcomes of traumatic brain injury: the prognostic accuracy of various scores and models

Charry, José D.; Navarro-Parra, Sandra; Solano, Juan P.; Moscote-Salazar, Luís Rafael; Pinzón, Miguel A.; Tejada, Jorman H.

doi:10.5603/pjnns.a2018.0003

Cited by 11 publications

(16 citation statements)

References 23 publications

(32 reference statements)

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“…Majdan et al compared ROC AUC for the predictive value of Rotterdam and Marshall score and reported similar performance for the two scores. 22 Similar results were found in another study by Charry et al 18 Mata-Mbemba et al reported that Marshall score has as good predictive power as Rotterdam score. 7 Although Mata-Mbemba et al included a large number of patients, their study has high risk of bias due to concealment of allocation.…”

Section: Predictive Value Of the Marshall Ct Scoring Systemsupporting

confidence: 80%

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

Mishra

Ucros

Florez-Perdomo

et al. 2021

Indian Journal of Neurotrauma

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This article conducts a contemporary comparative review of the medical literature to update and establish evidence as to which framework among Rotterdam and Marshall computed tomography (CT)-based scoring systems predicts traumatic brain injury (TBI) outcomes better. The scheme followed was following the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines for literature search. The search started on August 15, 2020 and ended on December 31, 2020. The combination terms used were Medical Subject Headings terms, combination keywords, and specific words used for describing various pathologies of TBI to identify the most relevant article in each database. PICO question to guide the search strategy was: “what is the use of Marshall (I) versus Rotterdam score (C) in TBI patients (P) for mortality risk stratification (O).” The review is based on 46 references which included a full review of 14 articles for adult TBI patients and 6 articles for pediatric TBI articles comparing Rotterdam and Marshall CT scores. The review includes 8,243 patients, of which 2,365 were pediatric and 5,878 were adult TBI patients. Marshall CT classification is not ordinal, is more descriptive, has better inter-rater reliability, and poor performance in a specific group of TBI patients requiring decompressive craniectomy. Rotterdam CT classification is ordinal, has better discriminatory power, and a better description of the dynamics of intracranial changes. The two scoring systems are complimentary. A combination of clinical parameters, severity, ischemic and hemodynamic parameters, and CT scoring system could predict the prognosis of TBI patients with significant accuracy. None of the classifications has good evidence for use in pediatric patients.

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Section: Predictive Value Of the Marshall Ct Scoring Systemsupporting

confidence: 80%

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

Mishra

Ucros

Florez-Perdomo

et al. 2021

Indian Journal of Neurotrauma

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“…These prognostic features have been displayed graphically, enabling risk stratification in relation to outcome, and ultimately, provide a tool to aid in clinical decision making [8,9]. The CRASH and IMPACT models are continuously validated on new patient series [10][11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%

Selection of CT variables and prognostic models for outcome prediction in patients with traumatic brain injury

Khaki

Hietanen

Corell

et al. 2021

Scand J Trauma Resusc Emerg Med

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Background Traumatic brain injuries (TBI) are associated with high risk of morbidity and mortality. Early outcome prediction in patients with TBI require reliable data input and stable prognostic models. The aim of this investigation was to analyze different CT classification systems and prognostic calculators in a representative population of TBI-patients, with known outcomes, in a neurointensive care unit (NICU), to identify the most suitable CT scoring system for continued research. Materials and methods We retrospectively included 158 consecutive patients with TBI admitted to the NICU at a level 1 trauma center in Sweden from 2012 to 2016. Baseline data on admission was recorded, CT scans were reviewed, and patient outcome one year after trauma was assessed according to Glasgow Outcome Scale (GOS). The Marshall classification, Rotterdam scoring system, Helsinki CT score and Stockholm CT score were tested, in addition to the IMPACT and CRASH prognostic calculators. The results were then compared with the actual outcomes. Results Glasgow Coma Scale score on admission was 3–8 in 38%, 9–13 in 27.2%, and 14–15 in 34.8% of the patients. GOS after one year showed good recovery in 15.8%, moderate disability in 27.2%, severe disability in 24.7%, vegetative state in 1.3% and death in 29.7%. When adding the variables from the IMPACT base model to the CT scoring systems, the Stockholm CT score yielded the strongest relationship to actual outcome. The results from the prognostic calculators IMPACT and CRASH were divided into two subgroups of mortality (percentages); ≤50% (favorable outcome) and > 50% (unfavorable outcome). This yielded favorable IMPACT and CRASH scores in 54.4 and 38.0% respectively. Conclusion The Stockholm CT score and the Helsinki score yielded the closest relationship between the models and the actual outcomes in this consecutive patient series, representative of a NICU TBI-population. Furthermore, the Stockholm CT score yielded the strongest overall relationship when adding variables from the IMPACT base model and would be our method of choice for continued research when using any of the current available CT score models.

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“…Charry et al made use of Marshall classification, Rotterdam CT score, IMPACT and CRASH models in its evaluation. They compared all these prognostic tools and found that IMPACT model showed more accuracy than the other prognostic models and had higher sensitivity in predicting a 6-month mortality and 6-month unfavorable outcomes in patients with TBI [16,17]. Khaki et al agreed that Rotterdam CT score is a good prognostic tool and in their study they compared multiple prognostic models (Marshall classification, Rotterdam scoring system, Helsinki CT score and Stockholm CT score) and found Stockholm CT score with the overall strongest relationship when adding variables from the IMPACT base model.…”

Section: Discussionmentioning

confidence: 99%

Correlation of Glasgow Coma Scale with Head Computed Tomographic Findings in Patients with Traumatic Brain Injury in a Tertiary Hospital in Nnewi

KG,

ME,

et al. 2024

JAMPS

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Background: Traumatic brain injury is an injury that causes anatomical or functional damage to the cranium, meninges and the brain. It is a major health challenge that causes increased mortality among trauma patients. This creates the serious need to find ways of elucidating the seriousness and prognostic possibility of every head injury patients. This study will help classify the patients in such a way as to affect management and also predict outcome early in the treatment of patients with traumatic head injury. Aim of the Study: Aim of this study is to correlate the clinical assessment of head injury patients with Glasgow Coma Scale (GCS) and CT findings as classified with Rotterdam scoring system. Subjects and Methods: This prospective study of 170 patients with head injury presenting for CT scan, was carried out from October, 2017 to September, 2019, in the Radiology department of the Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi. All stable patients that were referred for head CT within this period were included in the study. Prior to the commencement of the study, informed consent, relevant clinical history and necessary physical examination are usually carried out on the patient or obtained from the care giver to ascertain the level of consciousness by Glasgow coma scale. The GCS grading used was as follows; a score of 3 - 8 (severe head injury), 9 - 12 (moderate head injury) and 13 - 15 (mild head injury). Patients were scanned using a 4 slice/gantry rotation capacity CT (General Electric (GE), HANGWEI MEDICAL SYSTEMS CO. LTD. Data obtained from the study pro-forma and the cranial CT findings of subjects, was entered and analysed using IBM SPSS (Statistical Package for Social Sciences), version 20.0. Armonk, NY, U.S.A, 2011. Results: A total of 170 patients were involved in the study which showed a high prevalence of traumatic head injury. More males were involved than females and the predominant age in the study is 21-30. There was a significant correlation between the GCS and the Rotterdam scoring system. Discussion: The findings that more males and the younger age group are more involved and that the Rotterdam scores are good indicators of the outcome are similar to the findings in other studies. Conclusion: This study showed that Rotterdam CT score system is a good prognostic tool in patients with traumatic brain injury.

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Outcomes of traumatic brain injury: the prognostic accuracy of various scores and models

Cited by 11 publications

References 23 publications

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

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

Selection of CT variables and prognostic models for outcome prediction in patients with traumatic brain injury

Correlation of Glasgow Coma Scale with Head Computed Tomographic Findings in Patients with Traumatic Brain Injury in a Tertiary Hospital in Nnewi

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