Correlation of Glasgow Coma Scale with Head Computed Tomographic Findings in Patients with Traumatic Brain Injury in a Tertiary Hospital in Nnewi

Abstract

Background: Traumatic brain injury is an injury that causes anatomical or functional damage to the cranium, meninges and the brain. It is a major health challenge that causes increased mortality among trauma patients. This creates the serious need to find ways of elucidating the seriousness and prognostic possibility of every head injury patients. This study will help classify the patients in such a way as to affect management and also predict outcome early in the treatment of patients with traumatic head injury. Aim of the Study: Aim of this study is to correlate the clinical assessment of head injury patients with Glasgow Coma Scale (GCS) and CT findings as classified with Rotterdam scoring system. Subjects and Methods: This prospective study of 170 patients with head injury presenting for CT scan, was carried out from October, 2017 to September, 2019, in the Radiology department of the Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi. All stable patients that were referred for head CT within this period were included in the study. Prior to the commencement of the study, informed consent, relevant clinical history and necessary physical examination are usually carried out on the patient or obtained from the care giver to ascertain the level of consciousness by Glasgow coma scale. The GCS grading used was as follows; a score of 3 - 8 (severe head injury), 9 - 12 (moderate head injury) and 13 - 15 (mild head injury). Patients were scanned using a 4 slice/gantry rotation capacity CT (General Electric (GE), HANGWEI MEDICAL SYSTEMS CO. LTD. Data obtained from the study pro-forma and the cranial CT findings of subjects, was entered and analysed using IBM SPSS (Statistical Package for Social Sciences), version 20.0. Armonk, NY, U.S.A, 2011. Results: A total of 170 patients were involved in the study which showed a high prevalence of traumatic head injury. More males were involved than females and the predominant age in the study is 21-30. There was a significant correlation between the GCS and the Rotterdam scoring system. Discussion: The findings that more males and the younger age group are more involved and that the Rotterdam scores are good indicators of the outcome are similar to the findings in other studies. Conclusion: This study showed that Rotterdam CT score system is a good prognostic tool in patients with traumatic brain injury.