Utility of the Marshall &amp; Rotterdam Classification Scores in Predicting Outcomes in Trauma Patients

Elkbuli, Adel; Shaikh, Saamia; McKenney, Kelly; Shanahan, Hunter; McKenney, Mark; McKenney, Kimberley L.

doi:10.1016/j.jss.2021.02.025

Cited by 12 publications

(5 citation statements)

References 15 publications

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“…The prognostic CT score was higher in patients not following commands at hospital discharge than in those following commands; however, the Cohen d value of the GCS score was larger. Numerous researchers have shown that early CT score findings have associations with in-hospital mortality [2,[8][9][10][11][12][13]. Unfortunately, we have been unable to readily identify any publication describing GOS results at the time of hospital discharge in relationship to early CT score results.…”

Section: Prognostic Ct Scorementioning

confidence: 90%

“…The GCS deficit was computed as 15 (normal GCS) minus the admission GCS value (study range, [3][4][5][6][7][8][9][10][11][12]. The CT-GCS deficit score was the sum of the prognostic CT score and the GCS deficit (theoretical study range, [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17].…”

Section: Study Design and Populationmentioning

confidence: 99%

“…Using Rotterdam and Marshall CT scores in 1,035 patients with TBI, Asim et al showed that increased scores were associated with in-hospital mortality [8]. In a study of patients from the United States, Elkbuli et al analyzed Rotterdam and Marshall CT scores and demonstrated that higher score values were associated with hospital mortality [9]. Further, an Indian investigation of 127 patients with TBI that used Rotterdam and Marshall CT score results found an association between hospital mortality and higher CT score values [10].…”

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confidence: 99%

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Traumatic Brain Injury Outcome Associations With Computed Tomography and Glasgow Coma Scale Score Interactions: A Retrospective Study

Dunham,

Huang,

Ugokwe

et al. 2024

Cureus

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BackgroundNumerous investigators have shown that early postinjury Glasgow Coma Scale (GCS) values are associated with later clinical outcomes in patients with traumatic brain injury (TBI), in-hospital mortality, and posthospital discharge Glasgow Outcome Scale (GOS) results. Following TBI, early GCS, and brain computed tomography (CT) scores have been associated with clinical outcomes. However, only one previous study combined GCS scores with CT scan results and demonstrated an interaction with in-hospital mortality and GOS results. We aimed to determine if interactive GCS and CT findings would be associated with outcomes better than GCS and CT findings alone. MethodologyOur study included TBI patients who had GCS scores of 3-12 and required mechanical ventilation for ≥five days. The GCS deficit was determined as 15 minus the GCS score. The mass effect CT score was calculated as lateral ventricular compression plus basal cistern compression plus midline shift. Each value was 1 for present. A prognostic CT score was the mass effect score plus subarachnoid hemorrhage (2 if present). The CT-GCS deficit score was the sum of the GCS deficit and the prognostic CT score. ResultsOne hundred and twelve consecutive TBI patients met the inclusion criteria. Patients with surgical decompression had a lower GCS score (6.0±3.0) than those without (7.7±3.3; Cohen d=0.54). Patients with surgical decompression had a higher mass effect CT score (2.8±0.5) than those without (1.7±1.0; Cohen d=1.4). The GCS deficit was greater in patients not following commands at hospital discharge (9.6±2.6) than in those following commands (6.8±3.2; Cohen d=0.96). The prognostic CT score was greater in patients not following commands at hospital discharge (3.7±1.2) than in those following commands (3.1±1.1; Cohen d=0.52). The CT-GCS deficit score was greater in patients not following commands at hospital discharge (13.3±3.2) than in those following commands (9.9±3.2; Cohen d=1.06). Logistic regression stepwise analysis showed that the failure to follow commands at hospital discharge was associated with the CT-GCS deficit score but not with the GCS deficit. The GCS deficit was greater in patients not following commands at three months (9.7±2.8) than in those following commands (7.4±3.2; Cohen d=0.78). The CT-GCS deficit score was greater in patients not following commands at three months (13.6±3.1) than in those following commands (10.5±3.4; Cohen d=0.94). Logistic regression stepwise analysis showed that failure to follow commands at three months was associated with the CT-GCS deficit score but not with the GCS deficit. The proportion not following commands at three months was greater with a GCS deficit of 9-12 (50.9%) than with a GCS deficit of 3-8 (21.1%; odds ratio=3.9; risk ratio=2.1). The proportion of not following commands at three months was greater with a CT-GCS deficit score of 13-17 (56.0%) than with a CT-GCS deficit score of 4-12 (18.3%; OR=5.7; RR=3.1). ConclusionThe mass effect CT score had a substantially better association with the n...

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Section: Prognostic Ct Scorementioning

confidence: 90%

Section: Study Design and Populationmentioning

confidence: 99%

mentioning

confidence: 99%

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Traumatic Brain Injury Outcome Associations With Computed Tomography and Glasgow Coma Scale Score Interactions: A Retrospective Study

Dunham,

Huang,

Ugokwe

et al. 2024

Cureus

View full text Add to dashboard Cite

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“…The Rotterdam CT score is a method created in 2005 to assess structural brain injury. Compared to the Marshall CT score, Rotterdam CT score added traumatic subarachnoid hemorrhage and intraventricular hemorrhage, simplified the score calculation system, and reduces the assessment difference between emergency department and NICU 21 . Studies have shown that the Rotterdam CT score can predict the mortality of adults and children TBI patients 22 – 24 , which is consistent with the results in our study.…”

Section: Discussionmentioning

confidence: 99%

Platelet-to-lymphocyte ratio predicts short-term mortality in patients with moderate to severe traumatic brain injury

Deng

2022

Sci Rep

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An easily accessible biomarker with good diagnostic power for patients with traumatic brain injury (TBI) was needed to predict the short-term mortality. Studies have shown that platelet-to-lymphocyte ratio (PLR) is a biomarker for patients with tumor. This study aimed to identify the relationship between PLR and short-term mortality in patients with moderate to severe TBI. This is a retrospective cohort study. We selected patients with moderate to severe TBI who were admitted to the emergency department of The First Affiliated Hospital of Zhengzhou University. Biomarkers were collected within 24 h after admission. To investigate their relationship with short-term mortality, Cox proportional hazards regression and ROC curve analysis were performed. A total number of 170 patients was included. 47 (27.6%) patients had died and 123 (72.4%) patients were survived by the end of the study. Patients with different Rotterdam CT score (HR = 1.571, 95%CI 1.232–2.002, p < 0.001) or PLR levels (HR = 1.523, 95%CI 1.110–2.090, p = 0.009) had significant different mortality rates. The AUC curve analysis showed that the AUC of Rotterdam CT score and PLR groups were 0.729 (95%CI 0.638–0.821, p < 0.001) and 0.711 (95%CI 0.618–0.803 p < 0.001), respectively. PLR level is an independent biomarker with great diagnostic power for short-term mortality in patients with moderate to severe brain injury.

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“…Four CT-based metrics-the Marshall, Rotterdam, Stockholm, and Helsinki scores-have been developed to predict patient mortality 6 months from the time of injury. [121][122][123] The Marshall classification system is the oldest and has been used extensively to inform prognostication after TBI. The Marshall score classifies the presence or absence of lesions with mass effect, compression of the basal cisterns, and deviations of structures from the midline.…”

Section: Multi-injury Ct Scoring Systemsmentioning

confidence: 99%

Prognostic Neuroimaging Biomarkers in Acute Vascular Brain Injury and Traumatic Brain Injury

Krawchuk,

Sharrock

2023

Semin Neurol

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Prognostic imaging biomarkers after acute brain injury inform treatment decisions, track the progression of intracranial injury, and can be used in shared decision-making processes with families. Herein, key established biomarkers and prognostic scoring systems are surveyed in the literature, and their applications in clinical practice and clinical trials are discussed. Biomarkers in acute ischemic stroke include computed tomography (CT) hypodensity scoring, diffusion-weighted lesion volume, and core infarct size on perfusion imaging. Intracerebral hemorrhage biomarkers include hemorrhage volume, expansion, and location. Aneurysmal subarachnoid biomarkers include hemorrhage grading, presence of diffusion-restricting lesions, and acute hydrocephalus. Traumatic brain injury CT scoring systems, contusion expansion, and diffuse axonal injury grading are reviewed. Emerging biomarkers including white matter disease scoring, diffusion tensor imaging, and the automated calculation of scoring systems and volumetrics are discussed.

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Utility of the Marshall & Rotterdam Classification Scores in Predicting Outcomes in Trauma Patients

Cited by 12 publications

References 15 publications

Traumatic Brain Injury Outcome Associations With Computed Tomography and Glasgow Coma Scale Score Interactions: A Retrospective Study

Traumatic Brain Injury Outcome Associations With Computed Tomography and Glasgow Coma Scale Score Interactions: A Retrospective Study

Platelet-to-lymphocyte ratio predicts short-term mortality in patients with moderate to severe traumatic brain injury

Prognostic Neuroimaging Biomarkers in Acute Vascular Brain Injury and Traumatic Brain Injury

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