CT findings and the prognostic value of the Koret CT score in cats with traumatic brain injury

Abstract

Objectives The aims of this study were to evaluate associations between abnormal head CT findings and outcome, and to examine the prognostic value of the Koret CT score (KCTS) in cats sustaining acute traumatic brain injury (TBI). Methods The medical records of cats hospitalised with TBI that underwent head CT scans within 72 h of admission were retrospectively reviewed. CT scans were evaluated independently by a radiologist and a neurologist who were blinded to the outcome. A KCTS and modified Glasgow Coma Scale (MGCS) were assigned to each cat and the association between abnormal CT findings, KCTS, MGCS and outcome were analysed. Results Fourteen cats were included in the study: nine (64.2%) survivors and five (35.7%) non-survivors. Of the nine cats that were discharged, one was a short-term survivor (10 days) and eight (57.1%) were long-term survivors (⩾6 months). Abnormal CT findings included lateral ventricle asymmetry/midline shift (42.8%), intracranial haemorrhage (35.7%), caudotentorial lesions (14.2%) and cranial vault fractures (14.2%), all of which were depressed. Intracranial haemorrhage was found to be significantly and negatively associated with short-term ( P = 0.005) and long-term ( P = 0.023) survival. KCTS was significantly associated with short-term survival ( P = 0.002) and long-term survival ( P = 0.004). A KCTS cut-off value of 2 yielded a 100% sensitivity and 100% specificity for short-term survival and 100% sensitivity and 80% specificity for long-term survival. A MGCS cut-off value of ⩾13 was associated with a 100% sensitivity and 100% specificity for short-term survival, and with a 100% sensitivity and 80% specificity for long-term survival. Conclusions and relevance KCTS, performed up to 72 h from injury, can be used as an additional diagnostic tool for the prediction of survival in cats with TBI.

Kraniomaxillofaziales Trauma bei der Katze

“…Mit einer korrekten und zeitnahen Versorgung des kraniomaxillofazialen Traumas ist die Prognose günstig, auch wenn das Neurokranium einbezogen ist 5 , 15 , 16 . Obwohl sich die Katzen scheinbar von dieser Art des Traumas gut erholen, gibt es keine spezifischen Studien zur Wiederherstellung der verschiedenen Funktionseinheiten.…”

Surgical interventions and outcome in a population of feline trauma patients

“…Both of these scores have been validated in dogs and cats 14,15 and can be used to guide triage, diagnostics, treatments, and monitor patient progress 16 . The ATT score has been found to be a better predictor of mortality, whereas the MGCS score may be more limited and was found to perform best when applied to head trauma patients 11,14,15,17,18 …”

“…16 The ATT score has been found to be a better predictor of mortality, whereas the MGCS score may be more limited and was found to perform best when applied to head trauma patients. 11,14,15,17,18 General treatment options for trauma include nonsurgical medical management, surgical procedures within an emergency room (ER; eg, wound debridement, laceration repairs), and surgical procedures within an operating room (OR; eg, orthopedic procedures, complex wound repairs, jaw fracture repairs). For the OR surgery population, a coordinated care plan between the emergency triage team and multiple specialty services may be required.…”