[1]曹成龙 李艳玲 宋　健 姚　顺 房　莉 闫　研 徐国政.急性中、重型颅脑损伤早期病死率的预测：Marshall CT分级和Rotterdam CT评分的比较[J].中国临床神经外科杂志,2017,(10):676-679.[doi:10.13792017.09/j.issn.1009-153X.2017.10.002]
　CAO Cheng-long,LI Yan-ling,SONG Jian,et al.Prediction of early death in patients with traumatic brain injury: a comparison between Marshall and Rotterdam CT scoring systems[J].,2017,(10):676-679.[doi:10.13792017.09/j.issn.1009-153X.2017.10.002]
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急性中、重型颅脑损伤早期病死率的预测：Marshall CT分级和Rotterdam CT评分的比较()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2017年10期
页码:
676-679
栏目:
论著
出版日期:
2017-10-25

文章信息/Info

Title:
Prediction of early death in patients with traumatic brain injury: a comparison between Marshall and Rotterdam CT scoring systems
文章编号:
1009-153X（2017）10-0676-04
作者:
曹成龙 李艳玲 宋　健 姚　顺 房　莉 闫　研 徐国政
430070 武汉，中国人民解放军武汉总医院神经外科
Author(s):
CAO Cheng-long;  LI Yan-ling;  SONG Jian;  DU Hao;  YAO Shun;  FANG Li;  YAN Yan;  XU Guo-zheng.
Department of Neurosurgery, Wuhan General Hospital, PLA, Wuhan 430070, China
关键词:
急性颅脑损伤; Marshall CT分级;  Rotterdam CT评分; 早期病死率; 预测
Keywords:
Traumatic brain injury;  Marshall CT scoring system;  Rotterdam CT scoring system;  Death rate;  Prediction
分类号:
R 651.1+5
DOI:
10.13792017.09/j.issn.1009-153X.2017.10.002
文献标志码:
A
摘要:
目的 探讨Marshall CT分级和Rotterdam CT评分对急性中、重型颅脑损伤（TBI）早期病死率的预测作用。方法 回顾性分析2014~2015年手术治疗的169例急性中、重型TBI的临床资料，伤后24 h内入院并行CT检查，计算Marshall CT分级和Rotterdam CT评分。以伤后14 d观察周期，判断早期死亡。结果 149例中，早期死亡20例，早期病死率为13.4%。与存活病人相比，早期死亡病人入院时GCS评分、运动评分更低（P<0.05），瞳孔变化发生率明显增高（P<0.05），Marshall和Rotterdam评分更高（P<0.05）。随着Marshall分级或Rotterdam评分增高，病死率也随之明显升高（P<0.05）。Marshall分级和Rotterdam评分对TBI早期病死率的预测都具有很好的辨别能力，但是Rotterdam评分[受试者工作特征曲线下面积（AUC）=0.852；95% CI：0.764~0.941]优于Marshall分级[AUC=0.800；95%CI：0.719~0.881]。结论 Marshall CT分级和Rotterdam CT评分都可以很好地预测急性中、重型TBI的早期病死率；由于Rotterdam CT评分包含蛛网膜下腔出血等，或许更适用于弥漫性轴索损伤。
Abstract:
Objective To verify the predictive effect of the Rotterdam CT scoring system on early mortality in the patients with traumatic brain injury (TBI). Methods The clinical data of 149 patients with moderate and severe TBI (GCS 3~12 points) were analyzed retrospectively, including following up data and so on 2 weeks after TBI. The abilities of Marshall and Rotterdam scoring systems to predict the early death in the patients with TBI were assessed by the areas under the receiver operating characteristic curve (AUC). Results The total death rate was 13.4% (20/149) 2 weeks after TBI. The early death rate was positively related to the scores less than 5 points of Marshall CT scoring system and the scores of the Rotterdam CT scoring system in the patients with TBI. The present results showed that the AUC of Marshall and Rotterdam CT scoring systems were 0.800 and 0.852 respectively in the patients with TBI. Conclusions The early death rate in the patients with moderate and severe TBI can be predicted by Marshall and Rotterdam scoring systems. Rotterdam scoring system is more proper for the prediction of the early death rate in patients with diffuse axonal injury because it includes the subarachnoid hemorrhage besides other variables included by Marshall CT scoring system.

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备注/Memo

备注/Memo:
基金项目：全军医学科技“十二五”重点项目（BWS11J066）作者单位：430070 武汉，中国人民解放军武汉总医院神经外科（曹成龙、李艳玲、宋　健、姚　顺、房　莉、闫　研、徐国政）通信作者：徐国政，E-mail：xu-gz@163.com
更新日期/Last Update: 1900-01-01