Background: Traumatic brain injury (TBI) results from external forces disrupting brain function, leading to structural damage and neurological deficit. Comparing the Helsinki CT score to the CT screening systems of Rotterdam and Marshall allowed us to examine its capacity to independently predict the long-term prognosis of TBI patients.
Methods: This prospective observational cohort study was carried out on 300 cases with TBI that was admitted for surgical or conservative treatment at the Neurosurgery Department and/or Neurosurgery Intensive Care Unit in Benha University Hospitals. All patients were subjected to clinical evaluation and radiological evaluation.
Results : Regarding unfavorable outcomes, All three scores independently predicted poor prognosis (cutoffs: >2 for Rotterdam, Marshall and Helsinki). Regarding mortality, Higher cutoffs indicated elevated risk (>3 for Rotterdam/Marshall and >5 for Helsinki). Regarding functional decline: Significant correlation with worsening mRS scores at follow-up
defined cutoff values and statistical significance (*p*2, >2, and >2 respectively, the Rotterdam Score, Marshall Score, and Helsinki Score are significant predictors of unfavorable outcomes in TBI. Rotterdam Score, Marshall Score, and Helsinki Score are significant predictor of mortality in traumatic brain injury, at a cut-off value of >3, >3, and >5 respectively.
The Helsinki score demonstrates comparable prognostic accuracy to established systems. All three tools effectively stratify TBI patients by mortality risk and long-term disability, supporting their integration into clinical decision making. Rotterdam, Marshall, and Helsinki Scores are significant predictors for the change in Modified Rankin score at the follow-up in TBI.
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