Use of Rotterdam CT Scores for Mortality Risk Stratification in Children With Traumatic Brain Injury*

Content Provider	Scilit
Author	Liesemer, Kate Riva-Cambrin, Jay Bennett, Kimberly Statler Bratton, Susan Tran, Henry Metzger, Ryan R. Bennett, Tellen
Copyright Year	2014
Description	Journal: Pediatric Critical Care Medicine The Rotterdam computed tomography (CT) score refined features of the Marshall score and was designed to categorize traumatic brain injury (TBI) type and severity in adults. The objective of this study was to determine whether the Rotterdam CT score can be used for mortality risk stratification after pediatric TBI. In children with moderate to severe TBI, a comparison of observed versus predicted mortality calculated using published model probabilities of adult mortality. Development and validation of a new pediatric mortality model using randomly selected prediction and validation samples from our cohort. A single level 1 pediatric trauma center. 632 children with moderate or severe TBI None. Sixteen percent (101/632) of the patients died prior to hospital discharge. The predicted mortality based on Rotterdam score for adults with moderate or severe TBI discriminated pediatric observed mortality well (AUC = 0.85, 95% confidence interval [CI] 0.80 – 0.89) but had poor calibration, overestimating or underestimating mortality for children in several Rotterdam categories. A predictive model based on children with moderate or severe TBI from the single center discriminated mortality well (AUC 0.80, 95% CI 0.68 – 0.91) and showed good calibration and overall fit. Children with TBI have better survival than adults in Rotterdam CT score categories representing less severe injuries, but worse survival than adults in higher score categories. A novel, validated pediatric mortality model based on the Rotterdam score is accurate in children with moderate or severe TBI and can be used for risk stratification.
Related Links	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4087067/pdf
Ending Page	562
Page Count	9
Starting Page	554
ISSN	15297535
DOI	10.1097/pcc.0000000000000150
Journal	Pediatric Critical Care Medicine
Issue Number	6
Volume Number	15
Language	English
Publisher	Ovid Technologies (Wolters Kluwer Health)
Publisher Date	2014-07-01
Access Restriction	Open
Subject Keyword	Journal: Pediatric Critical Care Medicine Critical Care Medicine Intensive Care Unit Craniocerebral Trauma Intracranial Hypertension
Content Type	Text
Resource Type	Article
Subject	Critical Care and Intensive Care Medicine Pediatrics, Perinatology and Child Health