Predicting outcomes of decompressive craniectomy: use of Rotterdam Computed Tomography Classification and Marshall Classification

Waqas, Muhammad; Shamim, Muhammad Shahzad; Enam, Syed Faaiz; Qadeer, Mohsin; Bakhshi, Saqib Kamran; Patoli, Iqra; Ahmad, Khabir

doi:10.3109/02688697.2016.1139047

Cited by 21 publications

(13 citation statements)

References 22 publications

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“…28 The authors concluded that the Rotterdam CT scoring system can be a relatively objective, simple, and practical tool to prognosticate the outcome in both adults and pediatric patients with TBI. 2,28,30,31 In our study, we found that easy-to-use model and result showed that the higher the Rotterdam CT score, the poorer the outcome (it is in agreement with published literature). 2,28,30,31…”

Section: Discussionsupporting

confidence: 91%

“…29 In the Rotterdam CT score, the authors included individual CT characteristics (i.e., the status of basal cisterns, midline shift, and types of mass lesions or intracranial hemorrhage) and combined them to develop a model to predict the outcome in patients with moderate to severe TBI who underwent decompressive craniectomy. 2,28,30,31 A study involving pediatric patients (<17 years) reports that children with lower scores have better survival outcome as compared with adults with same scoring, but children with higher Rotterdam CT scores have worst survival as compared with adults. 28 The authors concluded that the Rotterdam CT scoring system can be a relatively objective, simple, and practical tool to prognosticate the outcome in both adults and pediatric patients with TBI.…”

Section: Discussionmentioning

confidence: 99%

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Rotterdam Computed Tomography Score to Predict Outcome in Traumatic Brain Injury Patients

Singh

Hegde

Reddy

et al. 2016

IJNT

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Introduction?In this article, we describe our experience of using Rotterdam computed tomography (CT) score at index admission to predict the outcome in traumatic brain injury (TBI) patients. Materials and Methods?A total of 370 TBI patients admitted to the Neurosurgery Intensive Care Unit, Narayana Medical College and Hospital, Andhra Pradesh, between January 2014 and December 2014 were evaluated. Based on availability of emergency CT scan, these patients' charts were reviewed prospectively. CT scan findings were quantified using Rotterdam CT classification (basal cistern, midline shift, and intraventricular blood/subarachnoid blood). Patient characteristic, Glasgow Coma Scale (GCS) score, Rotterdam CT classification, and outcome were analyzed. Correlation between Rotterdam CT classification at index admission and outcome at discharge from the hospital, alive or dead, was assessed. Results?The mean age of patients was 39.19???15.18 years. Rotterdam CT score was significant (p?

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Rotterdam Computed Tomography Score to Predict Outcome in Traumatic Brain Injury Patients

Singh

Hegde

Reddy

et al. 2016

IJNT

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“…[ 15 16 17 18 19 ] Few other studies from our institute have evaluated Rotterdam score and optic nerve sheath diameter as predictors of functional outcomes and mortality in patients undergoing decompressive craniectomy. [ 20 21 ] Both are noninvasive methods of measuring ICP. Optic nerve sheath diameter was found to have no relationship with functional outcomes or mortality in patients undergoing DC.…”

Section: Discussionmentioning

confidence: 99%

Outcome of decompressive craniectomy in traumatic closed head injury

et al. 2018

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Objective:The aim of the current study was to observe functional outcomes of patients undergoing decompressive craniectomy (DC) for raised intracranial pressure (ICP) after blunt head injury and to assess possible predictive factors.Methodology:This study was a prospective cohort study which was conducted at Aga Khan University Hospital, Karachi over a period of 2 years (January 2015–December 2016). Adult patients, aged between 15 and 65 years of both genders undergoing DC during the study period were selected. Outcomes of DC were assessed at an interval of 3 months following injury using the Glasgow outcome score. The data were analyzed on IBM statistics SPSS version 21.Results:Seventy-two patients underwent DC for raised and refractory ICP. Glasgow Outcome Scale (GOS) at discharge, 1-month and 3-month follow-up were reported. GOS at 3-month follow-up showed 21 patients (29.2%) patients had a good recovery, moderate disability was reported in 16 patients (22.2%), and severe disability in 12 patients (16.7%), persistent vegetative state was seen in five patients (6.9%). Eighteen patients had in hospital mortality (25.0%). Tracheostomy and sphenoid fractures were found to be negative predictors of good functional outcome.Conclusions:DC is associated with an in hospital mortality of 25.0%. Favorable outcomes were seen in 51.4% patients. Tracheostomy and sphenoid fractures were negative predictors of good functional outcome. The results are comparable to international literature.

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“…In our study, we found good performance in the Rotterdam CT score to predict mortality, different studies have been commissioned to validate the Rotterdam performance finding that the CT score the 4 criteria of the RSS (i.e., basal cisterns absent, midline shift, epidural lesions, and intraventricular or subarachnoid hemorrhage) Us in our study we show a good performance score in the cohort of patients with TBI. [ 15 16 17 ]…”

Section: Discussionmentioning

confidence: 99%

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

Charry

Falla

Ochoa

et al. 2017

Journal of Neurosciences in Rural Practice

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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.

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Predicting outcomes of decompressive craniectomy: use of Rotterdam Computed Tomography Classification and Marshall Classification

Abstract: RCTS is an independent predictor of unfavourable outcomes and mortality among patients undergoing emergency DC.

Cited by 21 publications

References 22 publications

Rotterdam Computed Tomography Score to Predict Outcome in Traumatic Brain Injury Patients

Rotterdam Computed Tomography Score to Predict Outcome in Traumatic Brain Injury Patients

Outcome of decompressive craniectomy in traumatic closed head injury

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

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