The Influence of Serious Extracranial Injury on In-Hospital Mortality in Children with Severe Traumatic Brain Injury

被引:6
作者
Chao, Min [1 ]
Wang, Chia-Cheng [2 ]
Chen, Carl P. C. [1 ]
Chung, Chia-Ying [1 ]
Ouyang, Chun-Hsiang [2 ]
Chen, Chih-Chi [1 ]
机构
[1] Chang Gung Univ, Chang Gung Mem Hosp, Dept Phys Med & Rehabil, Taoyuan 33305, Taiwan
[2] Chang Gung Univ, Chang Gung Mem Hosp, Dept Traumatol & Emergency Surg, Taoyuan 33305, Taiwan
关键词
severe traumatic brain injury; children; serious extracranial injury; mortality; predictors; CONCOMITANT INJURIES; HEAD-INJURY; COAGULOPATHY; IMPACT; RISK;
D O I
10.3390/jpm12071075
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
(1) Background: Severe traumatic brain injury (sTBI) is the leading cause of death in children. Serious extracranial injury (SEI) commonly coexists with sTBI after the high impact of trauma. Limited studies evaluate the influence of SEI on the prognosis of pediatric sTBI. We aimed to analyze SEI's clinical characteristics and initial presentations and evaluate if SEI is predictive of higher in-hospital mortality in these sTBI children. (2) Methods: In this 11-year-observational cohort study, a total of 148 severe sTBI children were enrolled. We collected patients' initial data in the emergency department, including gender, age, mechanism of injury, coexisting SEI, motor components of the Glasgow Coma Scale (mGCS) score, body temperature, blood pressure, blood glucose level, initial prothrombin time, and intracranial Rotterdam computed tomography (CT) score of the first brain CT scan, as potential mortality predictors. (3) Results: Compared to sTBI children without SEI, children with SEI were older and more presented with initial hypotension and hypothermia; the initial lab showed more prolonged prothrombin time and a higher in-hospital mortality rate. Multivariate analysis showed that motor components of mGCS, fixed pupil reaction, prolonged prothrombin time, and higher Rotterdam CT score were independent predictors of in-hospital mortality in sTBI children. SEI was not an independent predictor of mortality. (4) Conclusions: sTBI children with SEI had significantly higher in-hospital mortality than those without. SEI was not an independent predictor of mortality in our study. Brain injury intensity and its presentations, including lower mGCS, fixed pupil reaction, higher Rotterdam CT score, and severe injury-induced systemic response, presented as initial prolonged prothrombin time, were independent predictors of in-hospital mortality in these sTBI children.
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页数:10
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