CT Score Combined With Clinical Indicators For Moderate And Severe Traumatic Brain Lesions Prognostic Evaluation Value Of Injured Patients

Part Ⅰ Study on the value of Rotterdam CT score,Marshall CT grade and Helsinki CT score for prognosis evaluation of patients with moderate and severe traumatic injuryObjectTo explore the correlation between Helsinki CT score、Rotterdam CT score and Marshall CT grade of the outcome in patients with moderate and severe traumatic brain injury(TBI).MethodsClinical data from 404 patients of moderate and severe TBI treated in the emergency room of The Eastern Theater Command General Hospital from June 2019 to June 2022 were retrospective reviewed,and Rotterdam CT score,Marshall CT grade and Helsinki CT score were calculated separately.Patients were observed for 28 d death and the GOS score after 3 months.ResultThe ROC curves for the three scores showed that the area under the curve for Rotterdam CT score,Helsinki CT score and Marshall CT grade predicting moderate to severe TBI 28 d mortality were 0.879,0.766 and 0.745,respectively.However,the area of the curve of Rotterdam CT score,Helsinki CT score and Marshall CT grade for predicting the early months prognosis of moderate and severe TBI was 0.940,0.784 and 0.891,respectively.ConclusionAll three CT scoring systems can predict the prognosis of moderate and severe TBI,and the Rotterdam CT score has a higher ability to predict the early mortality and prognosis of patients with moderate to severe TBI.Part Ⅱ Value study of Rotterdam CT score combined with GCS score for prognosis evaluation of moderate and severe craniocerebral injuryObjectTo evaluate the value of Rotterdam CT score combined with GCS score for early prognosis in patients with moderate and severe TBI.MethodsThe clinical data of 404 patients with moderate and severe TBI who were treated in the emergency room of The Eastern Theater Command General Hospital from June 2019 to June 2022 were retrospective reviewed.Correlation analysis and multiple logistic regression were used to analyze the factors affecting early prognosis in patients with moderate and severe TBI,and the value of Rotterdam CT score and GCS score to predict the prediction of prognosis was assessed using the ROC curve.ResultThe good prognosis group was significantly lower than the poor prognosis group,and the GCS score was significantly higher than the poor prognosis group(P<0.01);the correlation analysis showed that Rotterdam CT score was negatively correlated with GOS score and GCS score;Rotterdam CT score,GOS score and the area under the curve were 0.893,0.735 and 0.861,respectively,and the prediction ability of Rotterdam CT score and GCS score was higher than that of both alone.ConclusionBoth Rotterdam CT score and GCS score were independent risk factors of the poor patient prognosis,and the combination of the two predicted the highest early prognostic value in patients of moderate and severe TBI.Part Ⅲ Analysis of risk factors and risk assessment model of traumatic coagulopathy in moderate and severe traumatic brain injuryObjectIt aims to explore the risk factors and risk assessment model of moderate and severe traumatic injury.MethodsClinical data of 343 patients with moderate to severe TBI were retrospectively analyzed.According to whether TIC was divided into TIC group and the control group,the two clinical data groups were compared,univariate and multivariate Logistic analysis was conducted,and the risk assessment model was established,and compared the area under the working characteristic(ROC)curve(AUC)with APACHE Ⅱ score,DIC score and AIS score.ResultThe 28-day mortality rate in the TIC group was significantly higher than the control group,and the GOS score was lower than the control group after 3 months;the blood glucose,red blood cell count,prothrombin time and Rotterdam CT score were related to moderate and severe TIC to establish a risk assessment model.ConclusionBlood glucose,red blood cell count,prothrombin time and Rotterdam CT score are all independent risk factors for moderate to severe TBI and TIC.The establishment of risk assessment model is conducive to the early identification and treatment of TIC in patients with moderate to severe TBI,so as to improve the clinical outcome of patients.