Travmatik Beyin Hasarı olan yaşlı hastalarda Prognostik Bilgisayarlı Tomografi Skorları karşılaştırması: Retrospektif bir çalışma

Giriş Rotterdam Bilgisayarlı Tomografi (BT) skorlama ve Helsinki BT skorlama sisteminin geriatrik popülasyonda TBH (travmatik beyin hasarı) sonrası 30 günlük mortaliteyi tahmin etme yeteneklerinin karşılaştırmasını sağlamayı amaçlamaktadır. Metod Acil servise travma ilişkili şikayetlerle başvuran 65 yaş ve üstü hastalar ICD kodları üzerinden retrospektif olarak tarandı ve izole kafa travması mevcut olup beyin BT ile tetkik edilmiş olan hastalar çalışmaya dahil edildi. Hastaların yaş, cinsiyet gibi demografik verileri, travma mekanizmaları, geliş muayenesinde Glasgow Koma Skalası (GKS), ışık refleksi bilgileri, entübe olup olmadığı ve opere olup olmadığı, acil servis sonlanım bilgisi taranarak kaydedildi. Hastaların beyin BT görüntüleri incelenerek Rotterdam ve Helsinki BT skorları hesaplandı ve bunlar arasındaki ilişkiye bakıldı. Bulgular Çalışmamıza dahil edilen 890 hastanın 403 (%45.3) erkekti. Çalışmamızda 683 hastanın 1 metreden daha düşük yükseklikten düştüğü, 195 tanesinin çarpma veya direkt darbe alma şeklinde olduğu görüldü. Hastaların bir aylık mortalite bilgisine bakıldığında 22 hastanın öldüğü ve 868 hastanın sağ olduğu saptandı. Erkek hastalarda ölüm oranı %3,7 iken kadın hastalarda bu oran %1,4 olarak bulunmuş olup mortalite açısından cinsiyetler arasında anlamlı fark saptandı. Hastaların Rotterdam ve Helsinki BT Skorları ve bir aylık mortaliteleri ROC analizi ile incelendiğinde Rotterdam BT Skoru için eğri altında kalan alan sırasıyla 0.564 ve 0.603 olarak bulundu. Hastaların Rotterdam BT Skoru ve Helsinki BT skoru 1 aylık mortaliteyi tahmin etmede spesifitesi sırayla %99,08 ve %99,19 olarak hesaplandı. Sonuç TBH ile başvuran geriatrik popülasyonda Rotterdam ve Helsinki gibi BT skorlamalarının kullanımı bize 30 günlük mortaliteyi tahmin etmemizi olanak sağlamaktadır.

Anahtar Kelimeler:

travmatik beyin hasarı, geriatri, acil servis, tomografi

Comparison of Prognostic Computed Tomography Scores in Geriatric Patients with Traumatic Brain Injury: A Retrospective Study

Aim This study aimed to compare the Rotterdam and Helsinki computed tomography (CT) scoring systems for predicting the 30-day mortality after traumatic brain injury (TBI) in the geriatric population. Materials and Methods Patients aged ≥65 years presenting to the emergency department with trauma-related complaints were retrospectively scanned using International Classification of Disease codes, and patients with isolated head trauma examined using brain CT were included. Demographic data including age, gender, trauma mechanisms, Glasgow Coma Scale (GCS) score at the time of admission, light reflex information, intubation, and surgery status, and emergency department outcomes were recorded. Brain CT images were investigated to calculate the Rotterdam and Helsinki CT scores and the relationship between them was examined. Results Of the 890 included patients, 403 (45.3%) were male. Overall, 683 patients fell from a height of <1 m and 195 suffered injuries by hitting or direct impact. Further, the 30-day mortality rate was examined, revealing that 868 patients were alive and 22 patients died. Mortality rate was 3.7% for males and 1.4% for females. The Rotterdam and Helsinki CT scores and 30-day mortality was analyzed using receiver operating characteristic curve analysis, and the area under the curve was found as 0.564 and 0.603, respectively. The specificity of Rotterdam and Helsinki CT scoring systems in predicting 30-day mortality was 99.08% and 99.19%, respectively. Conclusion The use of CT scoring systems such as Rotterdam and Helsinki in the geriatric population presenting with TBI allows us to predict 30-day mortality.

Keywords:

geriatrics, emergency department, tomography, traumatic brain injury,

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