Epidemiology and early predictive factors of mortality and outcome in children with traumatic severe brain injury: Experience of a French pediatric trauma center*

Ducrocq, Sarah; Meyer, Philippe; Orliaguet, Gilles; Blanot, Stéphane; Laurent-Vannier, A.; Rénier, Dominique; Carli, Pierre

doi:10.1097/01.pcc.0000235245.49129.27

Cited by 173 publications

(131 citation statements)

References 43 publications

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“…[14] More than 30% of these deaths can be prevented by quality primary treatment. [15] Quantitative trauma scoring systems are important methods of evaluating and comparing trauma treatment standards. [16] Males comprised the majority of the present population, in accordance with the findings of others.…”

Section: Discussionmentioning

confidence: 99%

Comparing Pediatric Trauma Score, Glasgow Coma Scale, and Injury Severity Score for Mortality Prediction in Traumatic Children

Yousefzadeh-Chabok

Leyli

Kouchakinejad–Eramsadati

et al. 2015

Ulus Travma Acil Cerrahi Derg

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Section: Discussionmentioning

confidence: 99%

Comparing Pediatric Trauma Score, Glasgow Coma Scale, and Injury Severity Score for Mortality Prediction in Traumatic Children

Yousefzadeh-Chabok

Leyli

Kouchakinejad–Eramsadati

et al. 2015

Ulus Travma Acil Cerrahi Derg

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“…Secondary insults, representing discrete events that may be monitored for and intervened upon, are predictable, potentially avoidable, and include systemic causes such as hypotension [93,94], hypocarbia, hypercarbia [78,79,95], hypoxia [11,96], hyperthermia [97], and hyperglycemia [98,99]. These insults result in secondary injuries which signify underlying neurological processes related to cellular and molecular mechanisms of injury/ death, including inflammatory responses, impairment of cerebral autoregulation, excitotoxicity, delayed cell death, and BBB breakdown [92].…”

Section: Secondary Insults and Injuriesmentioning

confidence: 99%

Cerebral Blood Flow and Autoregulation After Pediatric Traumatic Brain Injury

Udomphorn

Armstead

Vavilala

2008

Pediatric Neurology

133

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Traumatic brain injury is a global health concern and is the leading cause of traumatic morbidity and mortality in children. Despite a lower overall mortality than in adult traumatic brain injury, the cost to society from the sequelae of pediatric traumatic brain injury is very high. Predictors of poor outcome after traumatic brain injury include altered systemic and cerebral physiology, including altered cerebral hemodynamics. Cerebral autoregulation is often impaired following traumatic brain injury and may adversely impact poor outcome. Although altered cerebrovascular hemodynamics early after traumatic brain injury may contribute to disability in children, there is a paucity of information regarding changes in cerebral blood flow and cerebral autoregulation after pediatric traumatic brain injury. In this article, we discuss normal pediatric cerebral physiology and cerebrovascular pathophysiology following pediatric traumatic brain injury.

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“…For preverbal children, the pediatric coma scale is preferred. 25 In a large series of pediatric severe TBI, Ducrocq et al 9 reported that a threshold GCS score of 5 or less was associated with mortality and poor outcome. In our study, initial GCS demonstrated an association with different measures of CPP and PbtO 2 .…”

Section: Glasgow Coma Scalementioning

confidence: 99%

“…3,6,9,16 Given that sedation in the acute phase may influence 2 components of the GCS, (eye opening and verbal responses), the motor component of the GCS is often considered to represent a more reliable assessment. For preverbal children, the pediatric coma scale is preferred.…”

Section: Glasgow Coma Scalementioning

confidence: 99%

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Acute clinical grading in pediatric severe traumatic brain injury and its association with subsequent intracranial pressure, cerebral perfusion pressure, and brain oxygenation

Figaji

Zwane

Fieggen

et al. 2008

FOC

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Object The goal of this paper was to examine the relationship between methods of acute clinical assessment and measures of secondary cerebral insults in severe traumatic brain injury in children. Methods Patients who underwent intracranial pressure (ICP), cerebral perfusion pressure (CPP), and brain oxygenation (PbtO2) monitoring and who had an initial Glasgow Coma Scale score, Pediatric Trauma Score, Pediatric Index of Mortality 2 score, and CT classification were evaluated. The relationship between these acute clinical scores and secondary cerebral insult measures, including ICP, CPP, PbtO2, and systemic hypoxia were evaluated using univariate and multivariate analysis. Results The authors found significant associations between individual acute clinical scores and select physiological markers of secondary injury. However, there was a large amount of variability in these results, and none of the scores evaluated predicted each and every insult. Furthermore, a number of physiological measures were not predicted by any of the scores. Conclusions Although they may guide initial treatment, grading systems used to classify initial injury severity appear to have a limited value in predicting who is at risk for secondary cerebral insults.

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Epidemiology and early predictive factors of mortality and outcome in children with traumatic severe brain injury: Experience of a French pediatric trauma center*

Cited by 173 publications

References 43 publications

Comparing Pediatric Trauma Score, Glasgow Coma Scale, and Injury Severity Score for Mortality Prediction in Traumatic Children

Comparing Pediatric Trauma Score, Glasgow Coma Scale, and Injury Severity Score for Mortality Prediction in Traumatic Children

Cerebral Blood Flow and Autoregulation After Pediatric Traumatic Brain Injury

Acute clinical grading in pediatric severe traumatic brain injury and its association with subsequent intracranial pressure, cerebral perfusion pressure, and brain oxygenation

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