Deciphering the effectiveness of computed tomography scoring systems in improving mortality prediction for traumatic brain injury: a systematic review and bibliometric analysis

Abstract

PURPOSE: Traumatic brain injury is associated with adverse prognoses and significant neurological impairments that negatively affect patients' quality of life and physiological well-being. The aim of this study was to compare various computed tomography (CT) scoring systems in order to evaluate their effectiveness in predicting mortality and in risk stratification. METHODS: The evolution and trends in the use of CT scoring systems were analyzed through a bibliometric analysis of 72 Scopus-indexed documents using VOSviewer ver. 1.6.19. A systematic review was conducted following the 2020 PRISMA guidelines, with data obtained from PubMed Advance, Scopus, and Google Scholar for the period 2003-2024. A total of 198 journals were identified and subsequently filtered down to 6 that met the inclusion criteria. RESULTS: The bibliometric analysis revealed a progressive shift toward the use of CT scoring systems for novel diagnostic purposes and mortality prediction. The Rotterdam CT score demonstrated the highest total link strength and was most frequently published in 2017. In contrast, the Marshall CT score was more widely referenced in studies published after 2020. Despite being recognized for its sensitivity, the Helsinki CT score has not garnered equivalent research attention. Furthermore, the review suggested that the Rotterdam CT score is superior in predicting mortality among traumatic brain injury patients, with the Marshall CT score also demonstrating potential. CONCLUSIONS: A review of the extant literature indicates that the Helsinki CT score exhibits the highest predictive accuracy, effectively estimating both mortality probability and long-term prognosis. Since 2015, research on the Helsinki CT score has steadily increased.

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