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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 patientsjanuary 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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高氧血症和低碳酸血症是否增加了分娩期窒息后脑损伤的危险

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世界核心医学期刊文摘（儿科学分册） 2005年第5期1卷 26-27页

作者： Klinger G. beyene j. Shah P. Perlman M. 郭战宏 Hospital for Sick Children University of Toronto 555 University Avenue Toronto Ont. M5G 1X8 CanadaProf.

Background: Episodes of hyperoxaemia and hypocapnia, which may contribute to b rain injury, occur unintentionally in severely asphyxiated neonates in the first postnatal hours. Objective: To determine whether hyperoxaemia and/or hypocapnia during the first 2 hours of life add to the risk of brain injury after intrapar tum asphyxia. Methods: Retrospective cohort study in term infants with post-asp hyxial hypoxic ischaemic encephalopathy (HIE) born between 1985 and *** and moderate hyperoxaemia were defined as PaO2 > 26.6 and PaO2 > 13.3 kPa (20 0 and 100 mm Hg). Severe and moderate hypocapnia were defined as PaCO2 justed for initial disease severity. Results: Of 244 infants , 218 had known outcomes, 127 of which were adverse (64 deaths, 63 neurodevelopm ental deficits). Multivariate analyses showed an association between adverse out come and episodes of severe hyperoxaemia (odds ratio (OR) 3.85, 95%confidence interval (Cl) 1.67 to 8.88, p = 0.002), and severe hypocapnia (OR 2.34, 95% Cl 1.02 to 5.37, p = 0.044). The risk of adverse outcome was highest in infan ts who had both severe hyperoxaemia and severe hypocapnia (OR 4.56, 95%Cl 1.4 to 14.9, p = 0.012). Conclusion s: Severe hyperoxaemia and severe hypocapnia were associated with adverse outcom e in infantswith post-asphyxial HIE. During the first hours of life, oxygen sup plementation and ventilation should be rigorously controlled.

关键词：高氧低碳酸血症脑损伤缺血缺氧性脑病窒息新生儿出生后足月产儿回顾性队列研究多元分析疾病严重程度

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饱和与反式不饱和脂肪酸摄入与全因病死率、发生心血管疾病和2型糖尿病的风险：对观察性研究的系统性综述和荟萃分析

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英国医学杂志中文版 2016年第2期19卷 65-65页

作者： Russell j deSouza Andrew Mente Adriana Maroleanu Adrian I Cozma Vanessa Ha Teruko Kishibe Elizabeth Uleryk Patrick Budylowski Holger Schtinemann joseph beyene Sonia S Anand 金奥铭朱一丹不详北京大学医学部乔治健康研究所

目的系统性综述饱和脂肪和反式不饱和脂肪的摄入与全因病死率、心血管疾病及其相关死亡、冠心病及其相关死亡、缺血性卒中及2型糖尿病的相关性。

关键词：心血管疾病糖尿病脂肪酸全因病死率

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新生儿窒息后缺氧缺血性脑病:出生后4h内的结果预测规则

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世界核心医学期刊文摘（儿科学分册） 2006年第12期2卷 19-19页

作者： Shah P.S. beyene j. To T. 平智广 Department of Paediatrics Mount Sinai Hospital600 University AveTorontoOnt. M5G 1X5Canada

Objectives:To construct and validate a model and derive a simple rule that is usable in any birth location for the prediction of outcome of term infants with severe asphyxia. Design:Retrospective cohort study. Setting:Regional outborn neonatal intensive care unit. Participants:Infants with postintrapartum asphyxial hypoxic-ischemic encephalopathy (n = 375). Main Exposures:Clinical and laboratory predictors available at age 4 hours. Main Outcome Measures:A logistic regression model was developed and internally validated (with random sampling and based on the year of birth) for severe adverse outcome,which was defined as death or severe disability (severe cerebral palsy,severe developmental delay,sensorineural deafness,or cortical blindness singly or in com bination). A simple prediction rule was derived from 3 variables. Results:Complete data were available for 302 (92%) of the 345 infants with known outcomes (204 infants with severe adverse outcome). Six independent predictors of outcomes were identified. Using the 3 most significant predictors (chest compressions,age at onset of respiration,and base deficit),severe adverse outcome rates were 46%(95%confidence interval,33%-58%) with none of the 3 predictors,64%(95%confidence interval,54%-73%) with any 1 predictor,76%(95%confidence interval,66%-85%)with any 2 predictors,and 93%(95%confidence interval,81%-99%)-with all of the 3 predictors present. The internal validations revealed a robust model. Conclusions:This predictive model for neonatal hypoxic-ischemic encephalopathy provides a sliding scale of probabilities that could be used for prognostication and to design eligibility criteria for decision making including neuroprotective therapy.

关键词：缺氧缺血性脑病新生儿窒息出生后窒息性神经性聋感觉性单盲胸部按压回顾性队列研究预测模

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