Associate Professor University of Pittsburgh School of Medicine Pittsburgh, PA, US
Introduction: Traumatic brain injury (TBI) is one of the leading causes of death and neurological disability in the world. The Rotterdam Scoring System (RSS) attempts to prognosticate early mortality and early functional outcome in TBI patients based on non-contrast head computed tomographic (CT) imaging findings.
Methods: The purpose of this study is to identify the relationship between RSS scores and long-term outcomes in severe TBI patients. To accomplish this, consecutively treated severe TBI patients enrolled between 2008 and 2011 in the prospective, observational, Brain Trauma Research Center database were included. Demographic, clinical, and imaging data were analyzed for all patients. The Glasgow Outcome Scale (GOS) was used to measure long-term functional outcomes at 3-, 6-, 12-, and 24-months. GOS scores were categorized into favorable (GOS=4-5) and unfavorable (GOS=1-3) outcomes. RSS scores were calculated at the time of image acquisition and were treated as a categorical measure.
Results: Of the 168 patients in the database, 89 patients met all criteria and were included. Of those 89 patients, 74 (83.4%) were male, 81 (91.0%) were Caucasian, and the mean age of the cohort was 41.9 +/- 18.5 years old. Lower RSS scores correlated significantly with favorable functional outcomes and survival at all time points. Patients with an RSS score of 3 and lower were more likely to have a favorable outcome and had increased survival rates than patients with RSS scores greater than 3.
Conclusion : The RSS score on admission head CT in a cohort of severe TBI patients correlated with long-term survival and functional outcomes up to two years following injury.
