CC BY-NC-ND 4.0 · Indian Journal of Neurotrauma 2022; 19(02): 069-077
DOI: 10.1055/s-0041-1727404
Review Article

Predictive Value of Rotterdam Score and Marshall Score in Traumatic Brain Injury: A Contemporary Review

Rakesh Mishra
1   Department of Neurosurgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
,
Harold Enrique Vasquez Ucros
2   Department of Medicina General, Universidad del Sinú - Elias Bechara Zainúm de Cartagena, Cartagena, Colombia
3   Jefe de Investigacion ENCEPHALOS en Consejo LatinoAmericano de Neurointensivismo-CLaNi, Cartagena, Colombia
,
4   Department of Medicina General, Universidad Surcolombiana, Medico Investigador Consejo Latinoamericano de Neurointensivismo - CLaNi, Clinica Sahagún IPS SA, Cordoba, Columbia
,
José Rojas Suarez
5   Department of Medicina Intensiva, Epidemiologia Clinica, Intensive Care Research (GRICIO), Universidad de Cartagena, Corporacion Universitaria Rafael Nuñez, Cartagena, Colombia
,
Luis Rafael Moscote-Salazar
6   Department of Neurosurgery, University of Cartagena, Cartagena de Indias, Colombia
,
7   Department of Neurosurgery, Holy Family Red Crescent Medical College, Dhaka, Bangladesh
,
8   Department of Neurosurgery, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
› Author Affiliations

Abstract

This article conducts a contemporary comparative review of the medical literature to update and establish evidence as to which framework among Rotterdam and Marshall computed tomography (CT)-based scoring systems predicts traumatic brain injury (TBI) outcomes better. The scheme followed was following the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines for literature search. The search started on August 15, 2020 and ended on December 31, 2020. The combination terms used were Medical Subject Headings terms, combination keywords, and specific words used for describing various pathologies of TBI to identify the most relevant article in each database. PICO question to guide the search strategy was: “what is the use of Marshall (I) versus Rotterdam score (C) in TBI patients (P) for mortality risk stratification (O).” The review is based on 46 references which included a full review of 14 articles for adult TBI patients and 6 articles for pediatric TBI articles comparing Rotterdam and Marshall CT scores. The review includes 8,243 patients, of which 2,365 were pediatric and 5,878 were adult TBI patients. Marshall CT classification is not ordinal, is more descriptive, has better inter-rater reliability, and poor performance in a specific group of TBI patients requiring decompressive craniectomy. Rotterdam CT classification is ordinal, has better discriminatory power, and a better description of the dynamics of intracranial changes. The two scoring systems are complimentary. A combination of clinical parameters, severity, ischemic and hemodynamic parameters, and CT scoring system could predict the prognosis of TBI patients with significant accuracy. None of the classifications has good evidence for use in pediatric patients.



Publication History

Article published online:
15 April 2021

© 2021. Neurotrauma Society of India. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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