Department of Radiology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325027, China.
Department of Radiology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325027, China.
J Clin Neurosci. 2022 Jan;95:164-171. doi: 10.1016/j.jocn.2021.12.007. Epub 2021 Dec 17.
Marshall and Rotterdam are the most commonly used CT scoring systems to predict the outcome following traumatic brain injury (TBI). Although several studies have compared the performance of the two scoring systems in adult patients, none of these studies has evaluated the performance of the two scoring systems in pediatric patients. This study aimed to determine the predictive value of the Marshall and Rotterdam scoring systems in pediatric patients with TBI.
This retrospective study included 105 children with admission GCS < 12, with a mean age of 6.2 (±3.5) years. Their initial CT and status at hospital discharge (dead or alive) were reviewed, and both the Marshall and Rotterdam scores were calculated. We examined whether each score was related to the early death of pediatric patients.
The pediatric patients with higher Marshall and Rotterdam scores had a higher mortality rate. There was a good correlation between the Marshall and Rotterdam scoring systems (Spearman's rho = 0.618, significant at the 0.05 level). Both systems demonstrated a high degree of discrimination when predicting early mortality. The Marshall scoring system had reasonable discrimination (AUC 0.782), and the Rotterdam scoring system had good discrimination (AUC 0.729). Comparing the two CT scoring systems, the Marshall scoring system provided a better positive predictive value (90%) for early mortality than the Rotterdam scoring system (78%).
Both the Marshall and Rotterdam scoring systems have good predictability for assessing mortality in pediatric patients with TBI. The performance of the Marshall scoring system was equal to or slightly better than that of the Rotterdam scoring system.
Marshall 和 Rotterdam 是最常用于预测创伤性脑损伤（TBI）后结局的 CT 评分系统。虽然有几项研究比较了两种评分系统在成人患者中的表现，但这些研究均未评估两种评分系统在儿科患者中的表现。本研究旨在确定 Marshall 和 Rotterdam 评分系统在 TBI 儿科患者中的预测价值。
这是一项回顾性研究，纳入了 105 例入院时 GCS<12 的儿童患者，平均年龄为 6.2（±3.5）岁。回顾了他们的初始 CT 和出院时的状态（死亡或存活），并计算了 Marshall 和 Rotterdam 评分。我们研究了每个评分是否与儿科患者的早期死亡有关。
Marshall 和 Rotterdam 评分较高的儿科患者死亡率更高。Marshall 和 Rotterdam 评分系统之间存在良好的相关性（Spearman 相关系数为 0.618，在 0.05 水平上具有统计学意义）。两种系统在预测早期死亡率方面均具有较高的区分度。Marshall 评分系统具有合理的区分度（AUC 0.782），而 Rotterdam 评分系统具有良好的区分度（AUC 0.729）。比较两种 CT 评分系统，Marshall 评分系统对早期死亡率的阳性预测值（90%）高于 Rotterdam 评分系统（78%）。
Marshall 和 Rotterdam 评分系统均对评估 TBI 儿科患者的死亡率具有良好的预测性。Marshall 评分系统的性能与 Rotterdam 评分系统相当或略好。
