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Prognostic Value of the Brain CT-Scan in Head Trauma in Yaounde Central Hospital

Open Journal of Clinical Diagnostics 2023年第3期13卷 80-87页

作者： Freddy Mertens Bombah Ebogo Messina Figuim Bello Doulanni Bouba Pierre Ongolo Zogo Department of Surgery and Specialty Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Department of Oral and Maxillofcaila Surgery Faculty of Medicine Pharmacy and Odontology Cheikh Anta Diop University of Dakar Dakar Senegal Department of Surgery and Specialities Faculty of Medicine and Biomedical Sciences University of Yaounde Yaounde Cameroon Department of Medical Imaging and Radiation Therapy Faculty of Medicine and Biomedical Sciences University of Yaounde Yaounde Cameroon

Introduction: Cranial trauma is a serious medico-surgical pathology that hinders the vital and functional prognosis. The rotterdam computed tomography (CT) score refined features of the Marshall score. This score was designed to categorize traumatic brain injury (TBI) type and severity in adults. The aim of our research was to evaluate the association between the rotterdam CT scores of patients after a cranial traumatism in terms of survival. Material and methods: It was a cross-sectional and analytical study from January 2018 to March 2020, using medical records of patients suffering from cranial traumatism, received and taken in charge in the Yaounde central hospital. Results: 100 patients were retained out of 115 recruited patients. The average age was 35.20 with a sex ratio of 4.55. The rotterdam score was between 1 and 5 with a median of 2. The overall mortality at 6 months and 1 year was 32%. With an equal score compared to European studies, we recorded significantly higher mortality. We found the sequelae in 24% of the patients. GOS ranged from 1 to 5, and survival without sequelae (GOS 1) was the most represented. There was a positive correlation between the rotterdam score and the GOS with a Pearson correlation coefficient of +0.514. Conclusion: The death rate in rotterdam score equals is greater in our context compared to European studies.

关键词： Cranial Traumatism Cerebral CT-Scan Prognosis rotterdam score

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A comparative study between Marshall and rotterdam CT scores in predicting early deaths in patients with traumatic brain injury in a major tertiary care hospital in Nepal

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Chinese Journal of Traumatology 2016年第1期19卷 25-27页

作者： Sunil Munakomi Department of Neurosurgery College of Medical Sciences Bharatpur Nepal

OBJECTIVE:CT plays a crucial role in the early assessment of patients with traumatic brain injury (TBI). Marshall and rotterdam are the mostly used scoring systems, in which CT findings are grouped differently. We sought to determine the values of the scoring system and initial CT findings in predicting the death at hospital discharge (early death) in patients with TBI.;METHODS:There were consecutive 634 traumatic neurosurgical patients with mild-to-severe TBI admitted to the emergency department of College of Medical Sciences. Their initial CT and status at hospital discharge (dead or alive) were reviewed, and both CT scores were calculated. We examined whether each score is related to early death; compared the two scoring systems' performance in predicting early death, and identified the CT findings that are independent predictors for early death.;RESULTS:Both imaging score (Marshall) and clinical score (rotterdam) can be used to reliably predict mortality in patients with acute traumatic brain injury with high prognostic accuracy. Other specific CT characteristics that can be used to predict early mortality are traumatic subarachnoid hemorrhage, midline shift and status of the peri-mesencephalic cisterns.;CONCLUSIONS:Marshall CT classification has strong predictive power, but greater discrimination can be obtained if the individual CT parameters underlying the CT classification are included in a prognostic model as in rotterdam score. Consequently, for prognostic purposes, we recommend the use of individual characteristics rather than the CT classification. Performance of CT models for predicting outcome in TBI can be significantly improved by including more details of variables and by adding other variables to the models.

关键词： Brain injuries Tomography computed Prognosis Marshall score rotterdam score

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