Vol. 9, Issue 1, Part B (2025)

Traumatic brain injury (TBI) is a leading cause of mortality and morbidity globally, often requiring surgical interventions such as decompressive craniectomy (DC). Brain CT scans are essential for assessing prognosis in TBI patients, with Rotterdam and Helsinki CT scores widely utilized for mortality prediction. This retrospective cohort study aims to compare the prognostic accuracy of Rotterdam and Helsinki CT scores in predicting 30-day mortality among patients undergoing DC at Dr. M. Djamil General Hospital, Padang. Data were collected from 27 patients treated between January 2023 and November 2024. Patients underwent initial CT scans, which were evaluated using both scoring systems. Outcomes were recorded within 30 days postoperatively. Results revealed that 44.6% (12 patients) died, while 55.6% (15 patients) survived. Statistical analyses demonstrated a moderate correlation (r=0.657, p<0.001) for Rotterdam CT scores and a stronger correlation (r=0.748, p<0.001) for Helsinki CT scores with 30-day mortality. Receiver Operating Characteristic (ROC) analysis showed a higher Area under Curve (AUC) for Helsinki CT scores (0.944) compared to Rotterdam CT scores (0.878), indicating superior predictive accuracy. These findings suggest that Helsinki CT scores may provide a more reliable tool for mortality prediction in TBI patients undergoing DC.