Relevancia del puntaje de Rotterdam para el pronóstico de empeoramiento en pacientes con traumatismo encéfalocraneano

Abstract

Background: Rotterdam tomographic score has shown to be better than Marshall scale on the prognosis of the outcomes for patients with head trauma, but has not yet been assessed for prediction of worsening of intracranial lesions detected in the initial head computed tomography scan. Material and Method: A prospective study was conducted with patients with head trauma admitted at the Manuel Ascunce Domenéch University Hospital, Camagüey, Cuba, from July 1, 2011 to January 31, 2012. Patients evaluated with cerebral scan on admission and this test was repeated as a control during the same hospitalization period were included. Descriptive statistics techniques were applied, logistic regression and ANOVA. Results: 84 patients were studied, in 13 (15.5%) initial lesions worsening on a control cerebral scan that motivated the execution of urgent neurosurgical treatment. Increase Rotterdam score relationship with the occurrence of this complication was demonstrated. Conclusions: prognosis of patients with head trauma is not only relevant for mortality or poor results, but also with the risk of significant amplification of intracranial lesions detected in the initial head tomography scan, which offers the possibility to generate more opportune therapeutic changes. In this sense, the elevation of the Rotterdam scores in the initial head tomography scan is a risk factor.