Clinical Study On Relationship Between Red Blood Cell Distribution Width Combined With Helsinki CT Score,GCS Score And Prognosis Of Brain Injury

Objective: To investigate the value of red blood cell distribution width combined with Helsinki CT score and GCS score in the prognosis of patients with traumatic brain injury(TBI).METHODS: A total of 702 patients with TBI who were admitted to the emergency department of the First Affiliated Hospital of Soochow University from January 2016 to June 2018 were enrolled.Inclusion:(1).Have a clear history of head trauma and have a clear diagnosis by imaging examination;(2).Within 24 hours of injury to the emergency department of our hospital;(3).The case data is complete.Exclusions:(1).Age <16 years old(2).Serious injury with other organs or systems(3).History of anemia(4).Combined with cardiovascular disease(5).Combined with brain tumor or congenital cerebrovascular disease;(6).Patients with tumors.The venous blood samples were taken within 24 hours after the selected TBI patients,blood routine examination was performed,and RDW was obtained.GCS scores were immediately recorded by our resident physicians at the level of 15 minutes after admission,and recorded;TBI patients were scheduled to undergo CT within 30 minutes after admission.The Helsinki CT score was calculated and the survival and mortality of the patients were followed up for 30 days.Surviving patients were followed up,and the Glasgow Outcome Scale(GOS)score was scored at 6 months.This score <4 indicates poor prognosis,and a score of ≥4 was considered to have a good prognosis.The relationship between RDW,Helsinki CT score,GCS score and 30-day mortality of TBI patients and prognosis in June were analyzed.Results: 1.The 30-day mortality rate and the 6-month prognosis rate of TBI patients were positively correlated with the Helsinki score and GCS score.2.The Helsinki CT score of the death group was significantly higher than that of the survival group(P<0.001).The RDW value of the death group was slightly higher than that of the survival group(P<0.001),and the GCS score of the death group was significantly lower than that of the survival group(P<0.001).The Helsinki CT score was significantly higher than the prognosis group(P<0.001).The RDW value of the poor prognosis group was slightly higher than that of the prognosis group(P<0.001).The GCS score of the poor prognosis group was significantly lower than that of the prognosis group(P<0.001).3.There was a statistically significant difference in the value of RDW,Helsinki score,GCS score predicting 30-day prognosis and 6-month prognosis in patients with TBI(P<0.05),but the prediction of RDW value for 30-day prognosis and 6-month prognosis Low accuracy(AUC is less than 0.7).The area under the 30-day prognosis ROC curve was 0.674,0.937,and 0.935,respectively;the area under the prognostic ROC curve in June was 0.541,0.886,and 0.974,respectively.4.The area under the curve of RDW combined with Helsinki score and GCS score model is the largest(AUC=0.969).Conclusions: 1.The Helsinki CT score is valuable in predicting the prognosis of patients with traumatic cerebral hemorrhage.2.Immediate RDW combined with Helsinki score and GCS score can increase the value of 30-day mortality assessment for TBI patients,and the predictive value of prognosis for June is insufficient.