Evaluation of Head Computed Tomography Assessment of Brain Swelling after Acute Traumatic Brain Injury: A Pilot study
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Citações na Scopus
Tipo de produção
article
Data de publicação
2019
Título da Revista
ISSN da Revista
Título do Volume
Editora
GEORG THIEME VERLAG KG
Autores
Citação
BRAZILIAN NEUROSURGERY-ARQUIVOS BRASILEIROS DE NEUROCIRURGIA, v.38, n.4, p.257-262, 2019
Resumo
Objective To evaluate the interobserver reliability of a new scale created for quantitatively assessing brain swelling in traumatic brain injury (TBI) patients using the computed tomography (CT) findings in three levels. Methods Computed tomography scans of severe head injury patients were randomly selected from a tertiary hospital image database and evaluated by independent groups of neurosurgeons, neurosurgery residents, radiologists, and intensivists from the same hospital. Each specialist assessed the tomographic findings, applying zero to six points in a new scale. The Kappa coefficient was calculated to assess interobserver agreement. Results The highest reliability coefficient was obtained by the neurosurgeons group (0.791; 95% confidence interval [CI]: 0.975-0.607; p < 0.001), followed by the neurosurgery residents group (0.402; 95%CI: 0.569-0.236; p < 0.001) and by the radiologists group (0.301; 95%CI: 0.488-0.113; p < 0.002). The lowest coefficient was found among the intensivists (0.248; 95%CI: 0.415-0.081; p = 0.004). Conclusion The proposed scale showed good reliability among neurosurgeons, and moderate overall reliability. This tomographic classification might be useful to better assist severe TBI victims, allowing to identify the worsening or amelioration of brain swelling, which should be further investigated. The scale seems to be feasible, even in low income countries, where the cost of intracranial pressure (ICP) monitoring is higher than that of CTs.
Palavras-chave
brain injurytraumatic, tomography, critical care, prognosis
Referências
- Chesnut RM, 2012, NEW ENGL J MED, V367, P2471, DOI 10.1056/NEJMoa1207363
- Kesinger MR, 2014, INJURY, V45, P1350, DOI 10.1016/j.injury.2014.04.037
- Kraus J F, 1993, EPIDEMIOLOGY HEAD IN
- LANDIS JR, 1977, BIOMETRICS, V33, P159, DOI 10.2307/2529310
- Liu H, 2014, WORLD NEUROSURGERY
- Maas AIR, 2005, NEUROSURGERY, V57, P1173, DOI 10.1227/neu.0000186013.6304668
- Maas AIR, 2007, J NEUROTRAUM, V24, P303, DOI 10.1089/neu.2006.0033
- Majdan M, 2014, SCAND J TRAUMA RESUS, V22, DOI 10.1186/s13049-014-0068-9
- MARSHALL LF, 1992, J NEUROTRAUM, V9, pS287
- Mata-Mbemba D, 2014, ACAD RADIOL, V21, P605, DOI 10.1016/j.acra.2014.01.017
- Raj R, 2014, CRIT CARE, V18, DOI 10.1186/cc13814
- SOSIN DM, 1995, JAMA-J AM MED ASSOC, V273, P1778, DOI 10.1001/jama.273.22.1778
- Unterberg AW, 2004, NEUROSCIENCE, V129, P1021, DOI 10.1016/j.neuroscience.2004.06.046
- ZIMMERMAN RA, 1978, RADIOLOGY, V126, P403, DOI 10.1148/126.2.403
- ZIMMERMAN RA, 1978, RADIOLOGY, V127, P393, DOI 10.1148/127.2.393