The Predictive Value of GCS and Rotterdam CT Scoring Combined for the Prognosis of Moderate to Severe Traumatic Brain Injury Complications

WANG Pan; SHI Zeya; GAO Min; XU Furong; KUANG Xiaozhong; ZHANG ke; PENG Wenjuan

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Journal of Hunan Normal University(Medical Science) ›› 2024, Vol. 21 ›› Issue (6) : 79-84.

The Predictive Value of GCS and Rotterdam CT Scoring Combined for the Prognosis of Moderate to Severe Traumatic Brain Injury Complications

WANG Pan¹, SHI Zeya^1,2,3, GAO Min¹, XU Furong¹, KUANG Xiaozhong¹, ZHANG ke¹, PENG Wenjuan¹

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Abstract

Objective To explore the predictive value of Glasgow Coma Scale score (GCS), Rotterdam CT score and complications of moderate-to-severe traumatic brain injury (TBI) for its prognosis. Methods A retrospective collection was made of 144 patients with moderate-to-severe TBI admitted to our unit from January 2020 to December 2022. General information, GCS scores, Rotterdam CT scores and their complication conditions of the patients were collected. After a 6-month follow-up, according to the Glasgow Outcome Scale (GOS). Univariate and multivariate Logistic regression analyses were used to determine the independent risk factors for poor prognosis in patients with moderate-to-severe TBI. Receiver operating characteristic curves (ROC curves) were drawn and the predictive values of GCS, Rotterdam CT, complications in patients with moderate-to-severe TBI alone and in combination for poor prognosis were evaluated. Results There were 102 cases in the good - prognosis group and 42 cases in the poor-prognosis group. The discharge GCS score of the good - prognosis group was higher than that of the poor-prognosis group, while the Rotterdam CT score was lower than that of the poor-prognosis group. Multivariate Logistic regression analysis showed that the OR values of GCS score, Rotterdam CT score and complication of rebleeding were 0.8 (95%CI: 0.68-0.92), 1.63 (95%CI: 1.14-2.34)and14.58 (95%CI: 2.29-92.69) respectively, which were independent predictors of poor prognosis in patients with moderate-to-severe TBI. ROC curve analysis showed that GCS score, Rotterdam CT score and concurrent rebleeding all had predictive values for poor prognosis in patients with moderate-to-severe TBI. The combination of the three had the largest AUC, which was 0.850 (95%CI: 0.771-0.929), with a sensitivity of 78.57% and a specificity of 83.33%. Conclusion The combination of GCS, Rotterdam CT score and complication of rebleeding has the best effect on predicting the prognosis of patients with moderate -to-severe TBI.

Key words

traumatic brain injury / Glasgow coma scale / Rotterdam CT score / complications / Glasgow outcome scale

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WANG Pan, SHI Zeya, GAO Min, XU Furong, KUANG Xiaozhong, ZHANG ke, PENG Wenjuan. The Predictive Value of GCS and Rotterdam CT Scoring Combined for the Prognosis of Moderate to Severe Traumatic Brain Injury Complications[J]. Journal of Hunan Normal University(Medical Science). 2024, 21(6): 79-84

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