To compare the Glasgow coma score and CT based Rotterdam score in patients with TBI in Indian cohort. 

The current protocol for managing Traumatic Brain Injury (TBI) relies on the clinical GCS score and imaging with CT scan. Categorising patients on the basis of GCS score can lead to inconsistencies in management and thus Quantification of CT-Brain could help predict the outcomes in patients with TBI. 

This is the first Indian study to utilize the Rotterdam score in patients with TBI. We conducted a single-center, prospective, observational study. Patients with TBI were included after obtaining informed consent. Pregnant women and individuals under the age of 18 were excluded. Data was collected using the Kobo-tool. The outcome variables assessed were surgical intervention, ventilation, ICU stay, Glasgow Coma Scale (GCS) score at 72 hours, and outcome at discharge.

Total of 105 patients with TBI were studied; 71 male (67.62%) and mean age was 36.38 ± 16 years. The commonest cause of TBI was RTA in 96 (91.42%). Patients with Rotterdam score >3 required neurosurgical intervention, long ICU stays (22.33 ± 5.57), and had 100% mortality. Thus, a score of >3 signified 100% specificity and 85.7% sensitivity. The AUC was 0.979 with 95% confidence-interval (0.93-1.00) showing a high statistical significance (p<0.001). Compared to the 92.75% specificity and 100% sensitivity of GCS scoring system in our study.

The Rotterdam score is a more accurate and specific predictor of mortality in traumatic brain injury patients compared to the Glasgow Coma Scale. This makes it a valuable tool for assessing prognosis. However, further research with a larger sample size is necessary to solidify these findings.