Comparative Study On The Prognostic Value Of MEWS Score,Helsinki CT Score And CT Image Scoring In Patients With Traumatic Brain Injury

Objective:To study the value of GCS score,MEWS score,Helsinki CT score and CT image scoring in predicting the prognosis of patients with traumatic brain injury(TBI),and analyze the strength of the effectiveness between the scores,so as to provide a reference for finding a better scoring method to predict the prognosis of patients with traumatic brain injury in clinical work.Methods:(1)The clinical data of 100 TBI patients admitted to the neurosurgery department of the affiliated hospital of Youjiang Medical College for Nationalities from September 1,2020 to November 1,2022 were analyzed retrospectively.Collect clinical data of patients at admission,including age,sex,basic vital signs,state of consciousness,Glasgow Coma Scale(GCS),and CT imaging data within 24 hours of admission.(2)According to the collected data,the included TBI patients were scored with MEWS score,Helsinki CT score and CT image score.(3)The Glasgow Outcome Scale(GOS)was used to evaluate the prognosis of TBI patients 3 months after injury,and TBI patients were divided into good prognosis group(4-5 points)and poor prognosis group(1-3 points)according to the prognosis of patients.(4)SPSS27.0 was used for relevant data processing and analysis,and the age,GCS score,MEWS score,Helsinki CT score,CT image score and other data of the group with good prognosis and the group with poor prognosis were compared.The difference between data groups was analyzed by t-test and rank sum test,and the correlation between each data and TBI prognosis was analyzed by point-by-column correlation analysis,and the single factor analysis and multivariate logistic regression analysis were used to analyze whether each data was an independent risk factor affecting the prognosis of TBI.Finally,the ROC curve was calculated and drawn to analyze and compare the relationship between each score and the prognosis of TBI patients,and the evaluation was based on the area under curve(AUC),The AUC results obtained were used to compare the predictive value of each score on the prognosis of TBI patients.Results:(1)There was no statistically significant difference in age between the group with good prognosis and the group with poor prognosis of TBI patients(P>0.05),but there was statistically significant difference in GCS score,MEWS score,Helsinki CT score and CT image score(P<0.001).(2)GCS score,MEWS score,Helsinki CT score,CT image score and the prognosis of TBI patients have a strong correlation(P<0.001),in which GCS score and the prognosis of TBI patients have a negative correlation,while MEWS score,Helsinki CT score and CT image score have a positive correlation.(3)GCS score,MEWS score,Helsinki CT score and CT image score were independent risk factors for poor prognosis of TBI patients(P<0.001).(3)After comparing and analyzing the ROC curves drawn,the areas under the four scoring curves were: GCS score AUC=0.974(95% CI,0.943-1.000),MEWS score AUC=0.995(95% CI,0.988-1.000),Helsinki CT score AUC=0.978(95% CI,0.941-1.000),CT image score AUC=0.974(95% CI,0.936-1.000).The area under the curve obtained by MEWS score is the largest,the best critical value is 3.5,the sensitivity of MEWS score is1.000,and the specificity is 0.930.Conclusion:(1)GCS score,MEWS score,Helsinki CT score,and CT image score were independent risk factors for the 3-month poor prognosis of TBI patients.(2)The accuracy of GCS score,MEWS score,Helsinki CT score and CT image score in predicting the 3-month adverse prognosis of TBI patients is high.The prediction effect of GCS score and CT image score is the same,and the prediction effect of Helsinki CT score is better than the former two,while the prediction effect of MEWS score is the best.