Kashan University of Medical Sciences
Trauma Research Center, Kashan University of Medical Sciences
Outcome Prediction of traumatic brain injury (TBI)
among children is of great importance to accurate clinical decision making.
This study aimed to determine the prognostic value of Rotterdam scoring system in predicting early outcome among children with TBI.
This study was conducted in 2017 on 506 children with brain injury in Kashan, Iran. A checklist was used to collect demographic and clinical characteristics of patients such as age, gender, mechanism of trauma, Glasgow Coma Scale (GCS), need for surgery, and brain injury outcome. Moreover, each participant’s computed tomography scan was evaluated and scored using Rotterdam system. Sensitivity, specificity, positive and negative predictive values, and the best cutoff score were calculated for Rotterdam system. The relationships of Rotterdam score with participants’ characteristics were examined using the Chi-square test, while the predictors of brain injury outcome were identified using the logistic regression analysis.
Pediatric death rate was 4.3%. Most deaths were among children who were male, aged less than four, had developed brain injury due to traffic accidents, had a GCS score of 3–8, suffered from compressed skull fracture and frontal lobe injury, had cerebral edema, and had a Rotterdam score of 5. The sensitivity and specificity of Rotterdam score 3 were 86.4% and 97.9%, respectively. The logistic regression analysis indicated that only GCS and Rotterdam scores were significant predictors of brain injury outcome.
At a cutoff score of 3, Rotterdam system can be used to predict TBI outcome among children with acceptable sensitivity and specificity.