Neuroimaging with Rotterdam Scoring System and long-term outcomes in severe traumatic brain injury patients

Abstract

Purpose

The Rotterdam Scoring System (RSS) attempts to prognosticate early mortality and early functional outcome in patients with traumatic brain injury (TBI) based on non-contrast head computed tomography (CT) imaging findings. The purpose of this study was to identify the relationship between RSS scores and long-term outcomes in patients with severe TBI.

Methods

Consecutively treated patients with severe TBI enrolled between 2008 and 2011, in the prospective, observational, Brain Trauma Research Center database were included. The Glasgow Outcome Scale (GOS) was used to measure long-term functional outcomes at three, six, 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.

Results

Of the 89 patients included, 74 (83.4%) were male, 81 (91.0%) were Caucasian, and the mean age of the cohort was 41.9 ± 18.5 years old. Patients with an RSS score of 3 and lower were more likely to have a favorable outcome with increased survival rates than patients with RSS scores greater than 3.

Conclusions

The RSS score determined on the head CT scan acquired at admission in a cohort of patients with severe TBI correlated with long-term survival and functional outcomes up to two years following injury.

Keywords:

• Functional outcomes
• Glasgow Outcome Scale
• head injury
• Rotterdam Scoring

Author contributions

NA and DOO were involved in the design and conception of this manuscript. NA, SKA, ELN, TEW, HA, and RPK performed the literature search. NA, SKA, ELN, TEW, HA, and RPK compiled the primary manuscript. All authors critically revised the manuscript. All authors have approved the manuscript as it is written.

Disclosure statement

Dr. Nitin Agarwal receives royalties from Thieme Medical Publishers and Springer International Publishing.

Additional information

Funding

This work was supported, in part, by the National Institutes of Health (NS30318; Brain Trauma Research Center: Department of Neurosurgery, University of Pittsburgh).