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Comparison of the Ability of Marshall and Rotterdam CT Scan Scoring System in Determining the Prognosis of Traumatic Brain Injury Patients: A Cross-Sectional Study
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Alireza Rahat Dahmardeh   , Masoum Khoshfetrat , Aliakbar Keykha * |
| Community Nursing Research Center, Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Zahedan University of Medical Sciences, Zahedan, Iran , aliakbar.keykha@gmail.com |
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Abstract: (1054 Views) |
Background & Aim: Predicting the final outcome of patients with traumatic brain injury is crucial for making the right clinical decision and determining the course of treatment. The aim of this study was to compare the ability of Marshall and Rotterdam scoring systems to determine the prognosis in patients with traumatic brain injury.
Materials: The present research is a cross-sectional study. The statistical population of the study consisted of patients with traumatic brain injury admitted to the Intensive Care Unit (ICU) of Khatam al-Anbia Hospital in Zahedan from 2021 to 2022. In order to carry out this study, 287 patients were selected by convenience sampling method based on inclusion criteria. Patients were first evaluated by an intensive care physician to determine the prognosis with the APACH II Scale. The Marshall and Rotterdam scores of each patient were then determined by a radiologist based on a brain CT scan, and the patients were evaluated for the entire period of hospitalization until the final outcome (discharge or death) was determined. Finally, the data were compared to determine the ability of the two scales to predict outcomes.
Results: Out of the 287 patients, 33 (11/5%) died and 254 (88/5%) survived. The mean score of the Marshall Scale in the deceased patients was 4.69±1.01 and was 2.03±1.3 in the survived patients. The mean score of the Rotterdam Scale in the deceased patients was 5/33±0/95 and was 2/14±0/89 in the survived patients. In both cases, this difference was statistically significant (P=0/001). The mean score of the APACH II scale was 24/04±8/2 in the deceased patients and 16/08±7/3 in the survived patients. The correlation between Rotterdam and Marshall Scales in determining the outcome of patients, with APACH II was positive and high. The agreement between the APACH II and Rotterdam scales was greater in predicting mortality. The results of regression model showed that gender with (OR=2/91), head injury due to accident with (OR=3/04), Marshall Score above 4 (OR=1/97), Rotterdam score above 4 (OR=2/84) and Apache II score above 15 (OR=1/97) have a significant relationship with patient mortality.
Conclusion: According to the findings of the present study, it can be stated that both the Marshall and Rotterdam scales can determine the prognosis of patients with traumatic brain injury. |
Article number: 7 |
| Keywords: Traumatic Brain Injury, Marshall Classification System, Rotterdam CT Grading System, APACH II |
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Full-Text [PDF 1515 kb]
(399 Downloads)
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Type of Study: Research |
Subject:
Special
Received: 2022/05/16 | Accepted: 2022/06/22 | Published: 2022/06/22
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