Assessment of Recovery Following Pediatric Traumatic Brain Injury

Slovis, Julia; Gupta, Nachi; Li, Natasha Y.; Kernie, Steven G.; Miles, Darryl K.

doi:10.1097/pcc.0000000000001490

Cited by 22 publications

(17 citation statements)

References 23 publications

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“…Considering the overall outcome in our cohort of pediatric TBI patients, a GOSE score of 7 or 8 could be observed in 64% of cases. However, an unfavorable outcome (GOSE 1-4) was still present in 10% of pediatric TBI patients which is comparable to numbers from single-center studies reported from India (10%) and the United States (16%) (13,14). Independent predictors for an unfavorable outcome six months after TBI in pediatric patients who were admitted to the regular ward or ICU were GCS and the occurrence of secondary insults in multivariate analysis.…”

Section: Discussionsupporting

confidence: 71%

“…Similar to the results from the core dataset, brain injury was classified as serious to severe in most cases (AIS 3 (2-4) ). GCS ratings were also similar to the CENTER-TBI core study with a GCS of 15 (14)(15) in the admission stratum and 12 (7)(8)(9)(10)(11)(12)(13)(14)(15) in the ICU stratum. On brain CT, an abnormality was detected in 49% of pediatric TBI patients in the registry dataset.…”

Section: Comparison With the Center-tbi Registry Datasetsupporting

confidence: 63%

“…As expected, the total ISS and AIS Brain Injury scores in the ICU stratum were significantly higher than in the admission stratum (26 (17-41) vs. 10 (9-17), p < 0.001 and 4 (4-5) vs. 3 (3-3), p < 0.001, respectively). GCS as well as GCS-motor at admission were significantly higher in the admission stratum compared to the ICU stratum (15 vs. 11 (6)(7)(8)(9)(10)(11)(12)(13)(14); p < 0.00; and 6 (6-6) vs. 5 (1-6); p < 0.001). In the ICU stratum, 28% of patients had no motor response to stimuli at all and one in ten patients had two unresponsive pupils at admission.…”

Section: Injury Severity and Clinical Status At Admissionmentioning

confidence: 89%

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Injury Causes and Severity in Pediatric Traumatic Brain Injury Patients Admitted to the Ward or Intensive Care Unit: A Collaborative European Neurotrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) Study

et al. 2020

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Background: Traumatic brain injury (TBI) is the leading cause of death and disability in children. It includes a range of different pathologies that differ considerably from adult TBI. Analyzing and understanding injury patterns of pediatric TBI is essential to establishing new preventive efforts as well as to improve clinical management. Conclusion: Our study displays the most common injury causes and characteristics of pediatric TBI patients that are treated in the regular ward or ICU in Europe. Road-traffic incidents were especially common in ICU patients, indicating that preventive efforts could be effective in decreasing the incidence of severe TBI in children.

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Section: Discussionsupporting

confidence: 71%

Section: Comparison With the Center-tbi Registry Datasetsupporting

confidence: 63%

Section: Injury Severity and Clinical Status At Admissionmentioning

confidence: 89%

See 1 more Smart Citation

Injury Causes and Severity in Pediatric Traumatic Brain Injury Patients Admitted to the Ward or Intensive Care Unit: A Collaborative European Neurotrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) Study

et al. 2020

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“…A recent long-term follow-up study suggested that young children with pediatric traumatic brain injury that were discharged with an unfavorable status were associated with a higher probability of a continuing unfavorable outcome [20]. Predicting short-term poor outcome for young children with abusive head trauma helps clinicians, patients, and their families not only in knowing the prognosis at discharge but also in determining the appropriate long-term care preparations.…”

Section: Introductionmentioning

confidence: 99%

Clinical Characteristics and Predictors of Poor Hospital Discharge Outcome for Young Children with Abusive Head Trauma

Chen

Hsieh

Chen

et al. 2019

JCM

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Children with abusive head trauma tend to have worse outcomes than children with accidental head trauma. However, current predictors of poor outcomes for children with abusive head trauma are still limited. We aim to use clinical data to identify early predictors of poor outcome at discharge in children with abusive head trauma. In the 10-year observational retrospective cohort study, children aged between zero and four years with abusive or accidental head trauma were recruited. Multivariate logistic regression models were applied to evaluate factors associated with poor prognosis in children with abusive head trauma. The primary outcome was mortality or a Glasgow Coma Scale (GCS) motor component score of less than 6 at discharge. A total of 292 head trauma children were included. Among them, 59 children had abusive head trauma. In comparison to children with accidental head trauma, children with abusive head trauma were younger, had more severe head injuries, and experienced a higher frequency of post-traumatic seizures. Their radiologic findings showed common presence of subdural hemorrhage, cerebral edema, and less epidural hemorrhage. They were more in need of neurosurgical intervention. In the multivariate analysis for predictors of poor outcome in children with abusive head trauma, initial GCS ≤ 5 (versus GCS > 5 with the adjusted odds ratio (OR) = 25.7, 95% confidence interval (CI) = 1.5–432.8, p = 0.024) and older age (per year with the adjusted OR = 3.3, 95% CI = 1.2–9.5, p = 0.024) were independently associated with poor outcome. These findings demonstrate the characteristic clinical differences between children with abusive and accidental head trauma. Initial GCS ≤ 5 and older age are predictive of poor outcome at discharge in children with abusive head trauma.

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“…There are also several studies examining the GOS-E in children with traumatic brain injury. (8,23,34) Neuroimaging and neurophysiological tools frequently used for diagnosis included MRI and CT scans and electroencephalography. Responses are consistent with the literature showing that CT and MRI are useful to quantify structural brain disruption post-injury in children, (35) whereas electroencephalography detects factors potentially influencing clinical assessment…”

Section: Guidelinesmentioning

confidence: 99%

International survey on diagnostic and prognostic procedures in pediatric disorders of consciousness

et al. 2019

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Assessment of Recovery Following Pediatric Traumatic Brain Injury

Cited by 22 publications

References 23 publications

Injury Causes and Severity in Pediatric Traumatic Brain Injury Patients Admitted to the Ward or Intensive Care Unit: A Collaborative European Neurotrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) Study

Injury Causes and Severity in Pediatric Traumatic Brain Injury Patients Admitted to the Ward or Intensive Care Unit: A Collaborative European Neurotrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) Study

Clinical Characteristics and Predictors of Poor Hospital Discharge Outcome for Young Children with Abusive Head Trauma

International survey on diagnostic and prognostic procedures in pediatric disorders of consciousness

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