The Rotterdam CT score is an advanced tool used to evaluate the severity of traumatic brain injury (TBI) based on specific findings from a non-contrast head CT scan. This assessment is crucial for clinicians to predict the 6-month mortality outcomes for patients who have suffered a TBI.

Understanding the Rotterdam CT Score:

The Rotterdam score refines the predictive capabilities beyond the Marshall CT classification by focusing on distinct CT features associated with TBI outcomes. These features include the state of basal cisterns, the extent of midline shift, the presence of epidural mass lesions, and intraventricular or traumatic subarachnoid hemorrhage (tSAH).

Clinical Application:

The Rotterdam score is applied within 4 hours of injury, offering an early prognostic indicator that is instrumental in critical care and surgical decision-making. A higher score reflects a more severe injury and a greater risk of mortality, assisting healthcare providers in stratifying patients based on the severity and guiding discussions with patients' families.

Score Interpretation:

Each element of the CT findings is given a score, which is then summed to calculate the total Rotterdam score. This total score correlates with the expected 6-month mortality rate, helping to forecast the patient's chances of survival post-injury.

A score of 1 indicates a 0% 6-month mortality rate, reflecting the least severe injuries.

As the score increases, the associated mortality rate rises, with a score of 6 indicating a 61% mortality rate.

Integrating the Score into Patient Care:

The Rotterdam score is an integral part of the initial evaluation for TBI patients. It should be used in conjunction with other clinical assessments to paint a comprehensive picture of the patient's health status. While it offers quantitative insights, the score is not a definitive predictor of individual patient outcomes. Therefore, continuous clinical assessment and monitoring are essential for patient management.

In summary, the Rotterdam CT score is a vital assessment tool for healthcare professionals managing TBI patients. It provides a standardized method for assessing TBI severity, which is crucial for determining the most appropriate course of action and for predicting patient prognosis.