COMPARISON OF THE PROGNOSTIC VALUE OF HELSINKI AND ROTTERDAM COMPUTED TOMOGRAPHY SCORES FOR 3-MONTH MORTALITY IN PATIENTS WITH SEVERE TRAUMATIC BRAIN INJURY AT VIET DUC UNIVERSITY HOSPITAL
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Abstract
Objectives: To compare the prognostic performance of the Helsinki and Rotterdam computed tomography (CT) scoring systems in predicting 3-month mortality in patients with severe traumatic brain injury (TBI). Methods: A retrospective longitudinal study was conducted on 110 patients with Glasgow Coma Scale (GCS) ≤ 8 at Viet Duc University Hospital from June 2025 to September 2025. Clinical and imaging variables were collected, and scores were calculated according to the Helsinki and Rotterdam CT scoring systems. Prognostic performance was evaluated using receiver operating characteristic (ROC) curve analysis and Kaplan-Meier survival analysis. Results: The mean age was 44.4 ± 17.2 years, with males accounting for 82.7%. The most common lesion was subarachnoid hemorrhage (94.5%). The mean Rotterdam score was 3.39 ± 1.6, and the mean Helsinki score was 5.35 ± 3.5. The area under the curve (AUC) for the Rotterdam score was 0.766 (95%CI: 0.68 - 0.85), and for the Helsinki score was 0.760 (95%CI: 0.67 - 0.84), indicating comparable prognostic performance. At a cutoff value of ≥ 4, the Rotterdam score demonstrated higher specificity (77.1%), whereas the Helsinki score (a cutoff value of ≥ 5) showed higher sensitivity (72.6%). Kaplan-Meier analysis demonstrated significant risk stratification for mortality with both scoring systems (p < 0.001), with higher scores associated with increased mortality and shorter survival time. Conclusion: Both the Helsinki and Rotterdam CT scoring systems provide comparable prognostic value for 3-month mortality in severe TBI. The Helsinki score demonstrates higher sensitivity and better risk stratification, whereas the Rotterdam score is simpler and more specific.
Keywords
Traumatic brain injury, Rotterdam score, Helsinki score
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