title: Rotterdam computed tomography score as a prognosticator in head-injured patients undergoing decompressive craniectomy.
abstract: BACKGROUND
  The Rotterdam computed tomography (CT) score was developed for prognostic purposes in traumatic brain injury (TBI).
  
  
  OBJECTIVE
  To examine the prognostic discrimination and prediction of the Rotterdam CT score in the case of patients undergoing decompressive craniectomy (DC) for TBI.
  
  
  METHODS
  The CT scans with the worst findings before DC were scored according to the Rotterdam CT classification. Mortality and Glasgow Outcome Scale score at the end of follow-up were used as outcome measures. Unfavorable and favorable outcomes were defined by a Glasgow Outcome Scale score of 1 to 3 and 4 to 5, respectively. We used binary logistic and proportional odds regression for prognostic analyses.
  
  
  RESULTS
  The relationship between the Rotterdam CT score and prognosis was quantified, and higher scores indicated worse patient outcomes. Univariate analysis showed that the Rotterdam CT score was significantly associated with mortality (odds ratio: 3.117, 95% confidence interval: 1.867-5.386; P < .001) and unfavorable outcomes (odds ratio: 2.612, 95% confidence interval: 1.733-3.939; P < .001). After adjustment for published outcome predictors of TBI in multivariate regression, the Rotterdam CT score remained an independent predictor of unfavorable outcomes (odds ratio: 1.830, 95% confidence interval: 1.043-3.212; P = .035).
  
  
  CONCLUSIONS
  For head-injured patients undergoing DC, the Rotterdam CT score provides great prognostic discrimination and is an independent predictor of unfavorable outcomes. We suggest that the Rotterdam CT score be included as a prognosticator in the overall assessment of clinical condition of TBI patients before DC.
authors.affiliation: Department of Neurosurgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors.forename: Yu-Hua
authors.initials: YH
authors.lastname: Huang
authors.forename: Yu-Han
authors.initials: YH
authors.lastname: Deng
authors.forename: Tao-Chen
authors.initials: TC
authors.lastname: Lee
authors.forename: Wu-Fu
authors.initials: WF
authors.lastname: Chen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D002648:Child; D002675:Child, Preschool; D006259:Craniocerebral Trauma / Q000145:classification / Q000000981:diagnostic imaging* / Q000601:surgery*; D056424:Decompressive Craniectomy / Q000379:methods*; D005260:Female; D023261:Glasgow Outcome Scale; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D055815:Young Adult