BACKGROUND: Traumatic Brain Injury (TBI) in children has been poorly studied, and the literature is limited. We evaluated 146 children with severe TBI (coma score less than 8) in an attempt to establish the prognostic factors of severe TBI in children. METHODS: The severity of TBI was assessed via modified Glasgow Coma Score for those more than 3 years old and via Children Coma Score for those under 3 years old. Clinical presentations, laboratory parameters and features of Computerised Tomography brain scans were analyzed. Outcomes were assessed at 6 months with the Pediatric Cerebral Performance Categories Scale; the outcomes were categorised as good or poor outcomes. Correlations with outcome were evaluated using univariate and multivariate logistic models. RESULTS: A low coma score upon admission was independently associated with poor outcome. The presence of diabetes insipidus within 3 days post-TBI (OR: 1.9), hyperglycaemia (OR: 1.2), prolonged PT ratio (OR: 2.3) and leukocytosis (OR: 1.1) were associated with poorer outcome. CONCLUSION: Knowledge of these prognostic factors helps neurosurgeons and neurocritical care specialists to manage and improve outcome in severe TBI in children.
BACKGROUND:Traumatic Brain Injury (TBI) in children has been poorly studied, and the literature is limited. We evaluated 146 children with severe TBI (coma score less than 8) in an attempt to establish the prognostic factors of severe TBI in children. METHODS: The severity of TBI was assessed via modified Glasgow Coma Score for those more than 3 years old and via ChildrenComa Score for those under 3 years old. Clinical presentations, laboratory parameters and features of Computerised Tomography brain scans were analyzed. Outcomes were assessed at 6 months with the Pediatric Cerebral Performance Categories Scale; the outcomes were categorised as good or poor outcomes. Correlations with outcome were evaluated using univariate and multivariate logistic models. RESULTS: A low coma score upon admission was independently associated with poor outcome. The presence of diabetes insipidus within 3 days post-TBI (OR: 1.9), hyperglycaemia (OR: 1.2), prolonged PT ratio (OR: 2.3) and leukocytosis (OR: 1.1) were associated with poorer outcome. CONCLUSION: Knowledge of these prognostic factors helps neurosurgeons and neurocritical care specialists to manage and improve outcome in severe TBI in children.
Authors: Andrew I R Maas; Ewout W Steyerberg; Isabella Butcher; Ruben Dammers; Juan Lu; Anthony Marmarou; Nino A Mushkudiani; Gillian S McHugh; Gordon D Murray Journal: J Neurotrauma Date: 2007-02 Impact factor: 5.269
Authors: H S Levin; E F Aldrich; C Saydjari; H M Eisenberg; M A Foulkes; M Bellefleur; T G Luerssen; J A Jane; A Marmarou; L F Marshall Journal: Neurosurgery Date: 1992-09 Impact factor: 4.654
Authors: A Chiaretti; R De Benedictis; A Langer; C Di Rocco; C Bizzarri; A Iannelli; G Polidori Journal: Childs Nerv Syst Date: 1998-09 Impact factor: 1.475
Authors: Saeed Kayhanian; Adam M H Young; Chaitanya Mangla; Ibrahim Jalloh; Helen M Fernandes; Matthew R Garnett; Peter J Hutchinson; Shruti Agrawal Journal: Pediatr Res Date: 2019-07-26 Impact factor: 3.756
Authors: Shu-Ling Chong; Sumitro Harjanto; Daniela Testoni; Zhi Min Ng; Chyi Yeu David Low; Khai Pin Lee; Jan Hau Lee Journal: Int J Endocrinol Date: 2015-05-14 Impact factor: 3.257