Severe head injury among children: Prognostic factors and outcome

被引:23
作者
Bahloul, Mabrouk [1 ]
Ben Hamida, Chokri [1 ]
Chelly, Hedi [1 ]
Chaari, Adel [1 ]
Kallel, Hatem [1 ]
Dammak, Hassen [1 ]
Rekik, Noureddine [1 ]
Bahloul, Kamel [2 ]
Ben Mahfoudh, Kheireddine [3 ]
Hachicha, Mongia [4 ]
Bouaziz, Mounir [1 ]
机构
[1] Habib Bourguiba Univ Hosp, Dept Intens Care, Sfax, Tunisia
[2] Habib Bourguiba Univ Hosp, Dept Neurosurg, Sfax, Tunisia
[3] Habib Bourguiba Univ Hosp, Dept Radiol, Sfax, Tunisia
[4] Hedi Chaker Univ Hosp, Dept Paediat, Sfax, Tunisia
来源
INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED | 2009年 / 40卷 / 05期
关键词
Trauma; Acute head injury; Children; Intensive care unit; Motor vehicle accident; TRAUMATIC BRAIN-INJURY; COMA DATA-BANK; PEDIATRIC TRAUMA; INTENSIVE-CARE; SCORE; PREDICTORS; SCALE; CLASSIFICATION; HYPERGLYCEMIA; DEFINITIONS;
D O I
10.1016/j.injury.2008.04.018
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Aim: To determine predictive factors of mortality among children after traumatic brain injury. Methods: A retrospective study over 8 years of 222 children with severe head injury (Glasgow Coma Scale score <= 8) admitted to a university hospital (Sfax, Tunisia). Basic demographic, clinical, biological and radiological data were recorded on admission and during intensive care unit stay. Results: The study included 163 boys (73.4%) and 59 girls, with mean age 7.54 +/- 3.8 years. The main cause of trauma was road traffic accident (75.7%). Mean Glasgow Coma Scale score was 6 +/- 1.5, mean Injury Severity Score (ISS) was 28.2 +/- 6.9, mean Paediatric Trauma Score (PTS) was 3.7 +/- 2.1 and mean Paediatric Risk of Mortality (PRISM) was 14.3 +/- 8.5; 54 children (24.3%) died. Univariate analysis showed that low PTS on admission, high ISS or PRISM, presence of shock or meningeal haemorrhage or bilateral mydriasis, and serum glucose > 10 mmol l(-1) were associated with mortality rate. Multivariate analysis showed that factors associated with a poor prognosis were PRISM > 20 and bilateral mydriasis on admission. Conclusions: In Tunisia, head injury is a frequent cause of hospital admission and is most often due to road traffic accidents. Short-term prognosis is poor, with a high mortality rate (24.3%), and is influenced by demographic, clinical, radiological and biological factors. (C) 2008 Elsevier Ltd. All rights reserved.
引用
收藏
页码:535 / 540
页数:6
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