A death calls from unsafe heights. a study of factors influencing the outcome of surgically treated pediatric head trauma patients in baghdad

Abstract

Pediatric head injury accounts for a large number of admissions in emergency rooms, it is a major cause of morbidity and mortality in children over 1 year of age. The aim of this study is to assess the outcome of surgically treated pediatric patients with head trauma in Baghdad. Patients and methods : This prospective cross sectional study was conducted in neurosurgery hospital in Baghdad including fifty two patients of pediatric age group from 1 year to 14 years old with surgically operated head trauma, in the period from 1/10/2014 till 1/10/2015. All the patients were received; examined and managed properly and followed up till 6 months after surgery. The outcome was truly affected by the mechanism of injury (p=0.001), falls from heights was the most common mechanism and it was significantly related to mortality, it also increased the rate of disability, while it had no significance regarding a good functional recovery. There were associated orthopedic injuries which also affected the outcome significantly (p=0.01) increasing the mortality and disability. The outcome was truly affected by pediatric coma scale (p=0.001), functional recovery was increased with higher score and mortality increased with lower score, and disability increased in both severe and moderate scores. Pediatric trauma score had a significant effect on the outcome (p=0.001), in score (less than 0) it increased the mortality, in score(0-5) morbidity was increased. Falls from heights are the most common mechanism of pediatric head trauma and greatly affect the outcome. Concomitant orthopedic injuries are associated with poor outcome. pediatric coma scale, pediatric trauma score are significant tools in predicting outcome.