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Association of initial assessment variables and mortality in severe pediatric traumatic brain injury

World Journal of Pediatric Surgery 2024年第2期7卷 125-133页

作者： Katherine C Bergus Kelli N Patterson Lindsey Asti josh bricker Tariku J Beyene Lauren N Schulz Dana M Schwartz Rajan K Thakkar Eric A Sribnick Pediatric Surgery Nationwide Children's HospitalColumbusOhioUSA CenterforSurgical Outcomes Research Nationwide Children's HospitalColumbusOhioUSA Neurologic Surgery The Ohio State UniversityColumbusOhioUSA Neurologic Surgery Nationwide Children's HospitalColumbusOhioUSA

Background Predictive scales have been used to prognosticate long-term outcomes of traumatic brain injury(TBI),but gaps remain in predicting mortality using initial trauma resuscitation *** sought to evaluate the association of clinical variables collected during the initial resuscitation of intubated pediatric severe patients with TBI with in-hospital *** Intubated pediatric trauma patients<18 years with severe TBI(Glasgow coma scale(GCS)score≤8)from January 2011 to December 2020 were *** between initial trauma resuscitation variables(temperature,pulse,mean arterial blood pressure,GCS score,hemoglobin,international normalized ratio(INR),platelet count,oxygen saturation,end tidal carbon dioxide,blood glucose and pupillary response)and mortality were evaluated with multivariable logistic *** Among 314 patients,median age was 5.5 years(interquartile range(IQR):2.2-12.8),GCS score was 3(IQR:3-6),Head Abbreviated Injury Score(hAIS)was 4(IQR:3-5),and most had a severe(25-49)Injury Severity Score(ISS)(48.7%,153/314).Overall mortality was 26.8%.GCS score,hAIS,ISS,INR,platelet count,and blood glucose were associated with in-hospital mortality(all p<0.05).As age and GCS score increased,the odds of mortality *** 1-point increase in GCS score was associated with a 35%decrease in odds of *** hAIS,INR,and blood glucose increased,the odds of mortality *** each 1.0 unit increase in INR,the odds of mortality increased by 1427%.Conclusions Pediatric patients with severe TBI are at substantial risk for in-hospital *** are needed to examine whether earlier interventions targeting specific parameters of INR and blood glucose impact mortality.

关键词： mortality pediatric traumatic

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