OBJECTIVES: To determine the number of children with severe brain injury due to closed head injury or hypoxic-ischemic encephalopathy as a proportion of all admissions of children <3 yrs of age in the regional pediatric intensive care unit; to determine the outcome of these children at >6 mos postinjury; and to explore the relationship of outcome measures to predictors of outcome obtained within the first 24 hrs after brain injury. DESIGN: Prospective, descriptive outcome study of an inception cohort. RESULTS: Neonatal and Infant Follow-up Clinic, Glenrose Rehabilitation Hospital, Edmonton, Canada. PATIENTS: Of a cohort of 53 children of <3 yrs of age (4% of pediatric intensive care unit admissions, 1995-1998) admitted for severe acquired brain injury (Glasgow Coma Score, <or=8), 12 (23%) died, three (6%) were lost to follow-up, and 38 (71%) survived and received multidisciplinary outcome assessments. MEASUREMENTS AND MAIN RESULTS: Of 50 children with known outcome, 23 (46%) had a good recovery on the Glasgow Outcome Scale; however, only eight (16%) of these had average or above scores on both the mental and motor developmental indices of the Bayley Scales of Infant Development-II at 18-36 mos of age. Acute injury predictors of adverse outcome were apnea at scene, bolus epinephrine given for resuscitation, pupils nonreactive, arterial pH <or=7.2, and Glasgow Coma Score of 3. For 38 survivors, sensitivity and specificity from predictors for the Glasgow Outcome Scale were 73% and 83% respectively; for mental scores, 86% and 93%; for motor scores, 75% and 89%. CONCLUSIONS: Of children of <3 yrs of age identified by a Glasgow Coma Score of <or=8 after acute brain injury, >80% have adverse outcome of death, disability, or mental or motor developmental scores below average. A Glasgow Outcome Scale of 5 overestimates good recovery. Universal registry and follow-up of these children are needed.
OBJECTIVES: To determine the number of children with severe brain injury due to closed head injury or hypoxic-ischemicencephalopathy as a proportion of all admissions of children <3 yrs of age in the regional pediatric intensive care unit; to determine the outcome of these children at >6 mos postinjury; and to explore the relationship of outcome measures to predictors of outcome obtained within the first 24 hrs after brain injury. DESIGN: Prospective, descriptive outcome study of an inception cohort. RESULTS: Neonatal and Infant Follow-up Clinic, Glenrose Rehabilitation Hospital, Edmonton, Canada. PATIENTS: Of a cohort of 53 children of <3 yrs of age (4% of pediatric intensive care unit admissions, 1995-1998) admitted for severe acquired brain injury (Glasgow Coma Score, <or=8), 12 (23%) died, three (6%) were lost to follow-up, and 38 (71%) survived and received multidisciplinary outcome assessments. MEASUREMENTS AND MAIN RESULTS: Of 50 children with known outcome, 23 (46%) had a good recovery on the Glasgow Outcome Scale; however, only eight (16%) of these had average or above scores on both the mental and motor developmental indices of the Bayley Scales of Infant Development-II at 18-36 mos of age. Acute injury predictors of adverse outcome were apnea at scene, bolus epinephrine given for resuscitation, pupils nonreactive, arterial pH <or=7.2, and Glasgow Coma Score of 3. For 38 survivors, sensitivity and specificity from predictors for the Glasgow Outcome Scale were 73% and 83% respectively; for mental scores, 86% and 93%; for motor scores, 75% and 89%. CONCLUSIONS: Of children of <3 yrs of age identified by a Glasgow Coma Score of <or=8 after acute brain injury, >80% have adverse outcome of death, disability, or mental or motor developmental scores below average. A Glasgow Outcome Scale of 5 overestimates good recovery. Universal registry and follow-up of these children are needed.
Authors: R Scott Watson; Sheri S Crow; Mary E Hartman; Jacques Lacroix; Folafoluwa O Odetola Journal: Pediatr Crit Care Med Date: 2017-03 Impact factor: 3.624
Authors: Divine C Nwafor; Allison L Brichacek; Chase H Foster; Brandon P Lucke-Wold; Ahsan Ali; Mark A Colantonio; Candice M Brown; Rabia Qaiser Journal: J Cent Nerv Syst Dis Date: 2022-05-22
Authors: Ericka L Fink; Henry Alexander; Christina D Marco; C Edward Dixon; Patrick M Kochanek; Larry W Jenkins; Yichen Lai; Holly A Donovan; Robert W Hickey; Robert S Clark Journal: Pediatr Crit Care Med Date: 2004-03 Impact factor: 3.624
Authors: Hendrika Knoester; Madelon B Bronner; Albert P Bos; Martha A Grootenhuis Journal: Health Qual Life Outcomes Date: 2008-03-11 Impact factor: 3.186