Predicting outcomes of decompressive craniectomy: use of Rotterdam Computed Tomography Classification and Marshall Classification
| Autor: | Syed Faaiz Enam, Mohsin Qadeer, Muhammad Waqas, Saqib Kamran Bakhshi, Muhammad Shahzad Shamim, Iqra Patoli, Khabir Ahmad |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Male Pediatrics medicine.medical_specialty Decompressive Craniectomy Adolescent Traumatic brain injury medicine.medical_treatment Glasgow Outcome Scale Computed tomography Head trauma Cohort Studies 03 medical and health sciences Young Adult 0302 clinical medicine medicine Humans Glasgow Coma Scale 030212 general & internal medicine Aged medicine.diagnostic_test Receiver operating characteristic business.industry General Medicine Middle Aged medicine.disease Prognosis Treatment Outcome Brain Injuries Surgery Decompressive craniectomy Female Neurology (clinical) Intracranial Hypertension business Tomography X-Ray Computed 030217 neurology & neurosurgery Cohort study |
| Zdroj: | British journal of neurosurgery. 30(2) |
| ISSN: | 1360-046X |
| Popis: | Data on the evaluation of the Rotterdam Computed Tomography Classification (RCTS) as a predictor of outcomes in patients undergoing decompressive craniectomy (DC) for trauma is limited and lacks clarity.To explore the role of RCTS in predicting unfavourable outcomes, including mortality in patients undergoing DC for head trauma.This was an observational cohort study conducted from 1 January 2009 to 31 March 2013. CT scans of adults with head trauma prior to emergency DC were scored according to RCTS. A receiver operating characteristic curve analysis was performed to identify the optimal cut-off RCTS for predicting unfavourable outcomes [Glasgow outcome scale (GOS) = 1-3]. Binary logistic regression analysis was performed to evaluate the relationship between RCTS and unfavourable outcomes including mortality.One hundred ninety-seven patients (mean age: 31.4 ± 18.7 years) were included in the study. Mean Glasgow coma score at presentation was 8.1 ± 3.6. RCTS was negatively correlated with GOS (r = -0.370; p 0.001). The area under the curve was 0.687 (95% CI: 0.595-0.779; p 0.001) and 0.666 (95% CI: 0.589-0.742; p 0.001) for mortality and unfavourable outcomes, respectively. RCTS independently predicted both mortality (adjusted odds ratio for RCTS 3 compared with RCTS ≤3: 2.792, 95% CI: 1.235-6.311) and other unfavourable outcomes (adjusted odds ratio for RCTS 3 compared with RCTS ≤3: 2.063, 95% CI: 1.056-4.031).RCTS is an independent predictor of unfavourable outcomes and mortality among patients undergoing emergency DC. |
| Databáze: | OpenAIRE |
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