Performance of the necker cranial injury scale as a predictor of prognosis in children with severe traumatic brain injury: A retrospective cohort study

IF 1.5 4区医学 Q4 CLINICAL NEUROLOGY Neurochirurgie Pub Date : 2025-02-26 DOI:10.1016/j.neuchi.2025.101657

José Roberto Tude Melo , Isadora Araújo Santos Lobo , Luíza Malheiros Montagna , Sophia Totaro , Valentina Ponchio Vasques , Luciana Andrea Digieri Chicuto , Jean Gonçalves de Oliveira , José Carlos Esteves Veiga

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Abstract

Background and objective

The management of children with severe traumatic brain injury (TBI) is a challenge for the health team, and the use of scales and algorithms in clinical practice help in making certain decisions. The aim of this study is to evaluate the performance of the Necker Cranial Injury Scale (NCIS) in pediatric patients with severe TBI.

Methods

Retrospective cohort study with review of medical records of pediatric patients <17 years with severe TBI treated between January 2016 and December 2023 at a Brazilian reference trauma center. The analysis of the area under the curve (AUC) of the Receiver operating characteristic (ROC) was performed to check the performance of the NCIS and the Glasgow coma scale (GCS) as mortality predictive scales.

Results

We identified 45 pediatric patients with severe TBI, with a median age of 9 years (IQR 5–14), and a predominance of males (71%). There was a predominance of accidents on public roads (22 of 45, 49%) followed by home accidents (21 of 45, 47%). With a median score of 6 (IQR 5–8) on the GCS, the performance of the NCIS (AUC 0.92) was superior to the performance of the GCS (AUC 0.86). The NCIS 3 cutoff point showed a specificity of 89%, negative predictive value of 97%, and accuracy of 89%.

Conclusions

With excellent performance and high negative predictive value, the NCIS is efficient for use in clinical practice in children with severe TBI.

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来源期刊

Neurochirurgie 医学-临床神经学

CiteScore

2.70

自引率

6.20%

发文量

100

审稿时长

29 days

期刊介绍： Neurochirurgie publishes articles on treatment, teaching and research, neurosurgery training and the professional aspects of our discipline, and also the history and progress of neurosurgery. It focuses on pathologies of the head, spine and central and peripheral nervous systems and their vascularization. All aspects of the specialty are dealt with: trauma, tumor, degenerative disease, infection, vascular pathology, and radiosurgery, and pediatrics. Transversal studies are also welcome: neuroanatomy, neurophysiology, neurology, neuropediatrics, psychiatry, neuropsychology, physical medicine and neurologic rehabilitation, neuro-anesthesia, neurologic intensive care, neuroradiology, functional exploration, neuropathology, neuro-ophthalmology, otoneurology, maxillofacial surgery, neuro-endocrinology and spine surgery. Technical and methodological aspects are also taken onboard: diagnostic and therapeutic techniques, methods for assessing results, epidemiology, surgical, interventional and radiological techniques, simulations and pathophysiological hypotheses, and educational tools. The editorial board may refuse submissions that fail to meet the journal''s aims and scope; such studies will not be peer-reviewed, and the editor in chief will promptly inform the corresponding author, so as not to delay submission to a more suitable journal. With a view to attracting an international audience of both readers and writers, Neurochirurgie especially welcomes articles in English, and gives priority to original studies. Other kinds of article - reviews, case reports, technical notes and meta-analyses - are equally published. Every year, a special edition is dedicated to the topic selected by the French Society of Neurosurgery for its annual report.