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Objective To investigate the clinical practicability and prognostic value of Helsinki CT score in patients with traumatic brain injury(TBI).Methods A retrospective case series study was conducted to analyze the clinical data of 124 TBI patients admitted to First Affiliated Hospital of Xinjiang Medical University from September 2016 to October 2018.There were 91 males and 33 females,aged 14-84 years,with an average age of 49 years.Glasgow coma score(GCS)at admission ranged from 3-8 points in 45 patients,9-12 points in 42 patients,and 13-15 points in 37 patients.According to Glasgow outcome scale(GOS)at 6 months after injury,26 patients were classified into the poor prognosis group with GOS of 1-3 points and 98 patients were in the good prognosis group with GOS of 4-5 points.The prognosis-related risk factors were analyzed,and the role of Helsinki CT score to predict the adverse prognosis and mortality of TBI patients in the two groups was investigated.The sensitivity and specificity of Helsinki CT Score for 6-month poor prognosis were evaluated by receiver operation characteristic(ROC)curve and area under the curve(AUC).Results Univariate analysis suggested that there were significant differences in terms of subdural hematoma,intracranial hematoma,extradural hematoma,hematoma volume＞25 cm3,intraventricular hemorrhage and Suprasellar cistern pressure between the poor prognosis group and good prognosis group(P＜0.05).Multivariate logistic regression analysis showed that the mortality and bad prognosis were related to the hemorrhage of ventricles,the pressure of suprasellar cistern and the disappearance of suprasellar cistern in the poor prognosis group and the good prognosis group(P＜0.05),while intracranial hematoma and hematoma volume showed no association with mortality and poor prognosis(P＞0.05).The Helsinki CT score could independentiy predict the advetse prognosis and mortality of TBI patients at 6 months(multivariate logistic regression: ORdealth=1.21,ORadvene prognosis = 1.14).Helsinki CT score had a better predictive ability of 6-month mortality(AUC = 0.85)than that of 6-month advetse prognosis(AUC = 0.76),and had a predictive value for 6-month mortality and advetse prognosis.Conclusions Subdural hematoma,extradural hematoma,intraventricular hemorrhage and suprasellar cistern state(compression or disappearance)are the risk factots for the poor prognosis of TBI patients.Intraventricular hemorrhage and suprasellar cistern state are the main risk factots for predicting the mortality of 6 months.Helsinki CT score can independently predict the advetse prognosis and mortality of TBI patients at 6 months,and has relatively better value in predicting the mortality.
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Objective@#To investigate the clinical practicability and prognostic value of Helsinki CT score in patients with traumatic brain injury (TBI).@*Methods@#A retrospective case series study was conducted to analyze the clinical data of 124 TBI patients admitted to First Affiliated Hospital of Xinjiang Medical University from September 2016 to October 2018. There were 91 males and 33 females, aged 14-84 years, with an average age of 49 years. Glasgow coma score (GCS) at admission ranged from 3-8 points in 45 patients, 9-12 points in 42 patients, and 13-15 points in 37 patients. According to Glasgow outcome scale (GOS) at 6 months after injury, 26 patients were classified into the poor prognosis group with GOS of 1-3 points and 98 patients were in the good prognosis group with GOS of 4-5 points. The prognosis-related risk factors were analyzed, and the role of Helsinki CT score to predict the adverse prognosis and mortality of TBI patients in the two groups was investigated. The sensitivity and specificity of Helsinki CT Score for 6-month poor prognosis were evaluated by receiver operation characteristic (ROC) curve and area under the curve (AUC).@*Results@#Univariate analysis suggested that there were significant differences in terms of subdural hematoma, intracranial hematoma, extradural hematoma, hematoma volume >25 cm3, intraventricular hemorrhage and suprasellar cistern pressure between the poor prognosis group and good prognosis group (P<0.05). Multivariate logistic regression analysis showed that the mortality and bad prognosis were related to the hemorrhage of ventricles, the pressure of suprasellar cistern and the disappearance of suprasellar cistern in the poor prognosis group and the good prognosis group (P<0.05), while intracranial hematoma and hematoma volume showed no association with mortality and poor prognosis (P>0.05). The Helsinki CT score could independently predict the adverse prognosis and mortality of TBI patients at 6 months (multivariate logistic regression: ORdeath=1.21, ORadverse prognosis=1.14). Helsinki CT score had a better predictive ability of 6-month mortality (AUC=0.85) than that of 6-month adverse prognosis (AUC=0.76), and had a predictive value for 6-month mortality and adverse prognosis.@*Conclusions@#Subdural hematoma, extradural hematoma, intraventricular hemorrhage and suprasellar cistern state (compression or disappearance) are the risk factors for the poor prognosis of TBI patients. Intraventricular hemorrhage and suprasellar cistern state are the main risk factors for predicting the mortality of 6 months. Helsinki CT score can independently predict the adverse prognosis and mortality of TBI patients at 6 months, and has relatively better value in predicting the mortality.
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Objective To analyze the relationship between the optic nerve sheath diameter (ONSD) and the scoring of Glasgow Coma Scale(GCS)or CT score(Rotterdam CT score or Helsinki CT score).Methods Sixty-three adult patients with traumatic brain injury in our emergency room were enrolled.All the patients were presented with the data of GCS and the classification of cranial CT,as well as ONSD measured by ultrasound.The correlation between ONSD and classification of cranial CT scores or GCS was analyzed by Spearman correlation analysis.Patients were divided into mild group,moderate group and severe group based on GCS or CT scores.One-way Analysis of Variance (ANOVA) was used to discover the difference in mean ONSD among different groups on account of scoring of GCS or cranial CT scores.The intergroup comparisons were analyzed by the least-significant-difference (LSD) tests.Results ONSD measurements were strongly correlated with GCS(r=-0.540,P＜0.01)or classification of Rotterdam CT scores (r=0.654,P＜0.01) and Helsinki CT scores (r=0.663,P＜0.01).The mean ONSD of the mild,moderate and severe group were (3.89±0.70)mm,(4.50±0.65)mm and (4.81±0.72) mm,respectively.The mean ONSD of the mild group was significantly shorter than that of severe group (P＜0.01) and moderate group(P＜0.05).The same results were found when comparing mean ONSDs among different groups classified by Rotterdam CT scores (low group (3.74±0.64)mm vs.middle group (4.3 l±0.73)mm vs.high group (5.09±0.57)mm,P＜0.01 or P＜0.05) or classified by Helsinki CT scores (low group (3.54±0.61)mm vs.middle group (4.46±0.73)mm vs.high group (5.16±0.37)mm,P＜0.01.Conclusions Ultrasonography used to measure ONSD is significantly correlated with both GCS and classification of head CT including Rotterdam CT score and Helsinki CT score.The results indicate that ultrasonography measurement of ONSD is helpful for early bedside assessment in patients with traumatic brain injury.