Objective To analyze the predictive value of Glasgow Coma Scale (GCS) score, Full Outline of UnResponsiveness (FOUR) score, and Helsinki CT score on short-term prognosis in patients with severe traumatic craniocerebral hemorrhage (TCCH).
Methods A total of 150 patients with TCCH were collected as study objects, and were divided into death group (65 cases) and survival group (85 cases) according to outcome of 2-week prognosis. The differences of GCS score, FOUR score and Helsinki CT score were compared between the two groups. The correlations of FOUR score and Helsinki CT score with the GCS score were analyzed by Pearson correlation analysis. Multivariate Logistic regression analysis was used to investigate the correlations of FOUR score, Helsinki CT score and GCS score with prognosis.
Results The levels of D-dimer, prothrombin time (PT), activated partial thromboplastin time (APTT), international normalized ratio(INR) and platelet (PLT) count in the death group showed no significant difference compared with the survival group (P>0.05). The scores of FOUR and Helsinki CT score in the death group were higher, and the score of GCS was lower than that in the survival group (P < 0.05). The FOUR score and Helsinki CT score were negatively correlated with GCS scores (P < 0.05). FOUR score and Helsinki CT score were the risk factors to the prognosis of patients with TCCH (OR=2.913, P=0.036; OR=2.831, P=0.041), and GCS score was the protective factor to the prognosis of patients with TCCH (OR=0.756, P=0.029). The sensitivity, specificity and area under curve (AUC) in predicting death by GCS score, FOUR score and CT Score Scale score had no significant differences (P>0.05). The sensitivity, specificity and AUC of three scale scores in combination were 86.8%, 94.5% and 0.892(95%CI, 0.863 to 0.946; P < 0.05).
Conclusion The combination of GCS, FOUR and CT Score Scale scores can effectively evaluate the short-term prognosis of patients with TCCH.
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