Impact of Road Traffic Injury to Pediatric Traumatic Brain Injury in Southern Thailand

Tunthanathip, Thara; Phuenpathom, Nakornchai

doi:10.4103/jnrp.jnrp_381_17

Cited by 23 publications

(26 citation statements)

References 20 publications

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“…The most common cause of traffic injury in Thailand is motorcycle crashes. 12 24 Our study also found that motorcycle crashes were the leading cause of injury (62.2%), and a history of alcohol use may be responsible for these injuries; as 78.9% of these patients declared that they had been drinking alcohol before involvement in a motorcycle accident. Alcohol consumption may increase seizure threshold by acting on gamma-aminobutyric acid receptors, while cessation of drinking may lower seizure threshold with upregulation of N-methyl-D-aspartate receptor.…”

Section: Discussionsupporting

confidence: 55%

Predictive Risk Factors for Early Seizures in Traumatic Brain Injury

Parmontree

Tunthanathip

Doungngern

et al. 2019

Journal of Neurosciences in Rural Practice

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Background Early posttraumatic seizure (PTS) is a significant cause of unfavorable outcomes in traumatic brain injury (TBI). This study was aimed to investigate the incidence and determine a predictive model for early PTS. Materials and Methods A prospective cohort study of 484 TBI patients was conducted. All patients were evaluated for seizure activities within 7 days after the injury. Risk factors for early PTS were identified using univariate analysis. The candidate risk factors with p < 0.1 were selected into multivariable logistic regression analysis to identify predictors of early PTS. The fitting model and the power of discrimination with the area under the receiver operating characteristic (AUROC) curve were demonstrated. The nomogram for prediction of early PTS was developed for individuals. Results There were 27 patients (5.6%) with early PTS in this study. The final model illustrated chronic alcohol use (odds ratio [OR]: 4.06, 95% confidence interval [CI]: 1.64–10.07), epidural hematoma (OR: 3.98, 95% CI: 1.70–9.33), and Glasgow Coma Scale score 3–8 (OR: 3.78, 95% CI: 1.53–9.35) as predictors of early PTS. The AUROC curve was 0.77 (95% CI: 0.66–0.87). Conclusions The significant predictors for early PTS were chronic alcohol use, epidural hematoma, and severe TBI. Our nomogram was considered as a reliable source for prediction.

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Section: Discussionsupporting

confidence: 55%

Predictive Risk Factors for Early Seizures in Traumatic Brain Injury

Parmontree

Tunthanathip

Doungngern

et al. 2019

Journal of Neurosciences in Rural Practice

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“…10 Finally, the GOS scores were dichotomized into favorable (GOS scores 4 and 5) and unfavorable (GOS scores 1-3) categories. 2,28 The study was performed with the approval of the Ethics Committee of the Faculty of Medicine, Songklanagarind Hospital, Prince of Songkla University.…”

Section: Methodsmentioning

confidence: 99%

Blast-induced traumatic brain injury: the experience from a level I trauma center in southern Thailand

Tunthanathip¹,

Khocharoen²,

Phuenpathom³

2018

Neurosurgical Focus

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OBJECTIVEIn the ongoing conflict in southern Thailand, the improvised explosive device (IED) has been a common cause of blast-induced traumatic brain injury (bTBI). The authors investigated the particular characteristics of bTBI and the factors associated with its clinical outcome.METHODSA retrospective cohort study was conducted on all patients who had sustained bTBI between 2009 and 2017. Collected data included clinical characteristics, intracranial injuries, and outcomes. Factors analysis was conducted using a forest plot.RESULTSDuring the study period, 70 patients met the inclusion criteria. Fifty individuals (71.4%) were military personnel. One-third of the patients (32.9%) suffered moderate to severe bTBI, and the rate of intracerebral injuries on brain CT was 65.7%. Coup contusion was the most common finding, and primary blast injury was the most common mechanism of blast injury. Seventeen individuals had an unfavorable outcome (Glasgow Outcome Scale score 1–3), and the overall mortality rate for bTBI was 11.4%. In the univariate analysis, factors associated with an unfavorable outcome were preoperative coagulopathy, midline shift of the brain ≥ 5 mm, basal cistern effacement, moderate to severe TBI, hypotension, fixed and dilated pupils, surgical site infection, hematocrit < 30% on admission, coup contusion, and subdural hematoma. In the multivariable analysis, midline shift ≥ 5 mm (OR 29.1, 95% CI 2.5–328.1) and coagulopathy (OR 28.7, 95% CI 4.5–180.3) were the only factors predicting a poor outcome of bTBI.CONCLUSIONSbTBIs range from mild to severe. Midline shift and coagulopathy are treatable factors associated with an unfavorable outcome. Hence, in cases of bTBI, reversing an abnormal coagulogram is required as soon as possible to improve clinical outcomes. The management of brain shift needs further study.

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“…Penetrating traumatic brain injury (PTBI) is much less common than blunt traumatic brain injury [1]. Larkin et al .…”

Section: Introductionmentioning

confidence: 99%

Development and Validation of a Nomogram for Predicting the Mortality after Penetrating Traumatic Brain Injury

Tunthanathip

Udomwitthayaphiban

2019

BEAT

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Objective:To determine the factors associated with mortality in penetrating brain injury (PTBI) and proposed the nomogram predicting the risk of death. Methods:A retrospective cohort study was conducted on all patients who had sustained PTBI between 2009 and 2018. Collected data included clinical characteristics, neuroimaging findings, treatment, and outcomes. Prognostic factors analysis was conducted using a forest plot. Therefore, the nomogram was developed and validated. For the propose of evaluation, the nomogram’s sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), Receiver Operating Characteristic (ROC) curve and the area under the receiver operating characteristic (AUC) were determined for validating the optimal cut-off point of the total scores. Results:During the study period, 62 individuals enrolled. In the univariate analysis, factors associated with the morality were normal pupils’ reactivity to light (OR 0.04, p < 0.001), hypotension (OR 9.91, p<0.001), hypoxia (OR 10.2, p=0.04), bihemispheric injuries (OR 19.0, p=0.001), multilobar injuries (OR 21.5, p< 0.001), subarachnoid hemorrhage (OR 6.9, p= 0.02), intraventricular hemorrhage (OR 26.6, p= 0.006), basal cistern effacement (OR 28.8, , p<0.001), midline shift >5 mm (OR 0.19, p<0.001) were significantly associated with death. In multivariable analysis, hypotension (OR 8.82, p=0.03), normal pupils’ reactivity to light (OR 0.07, p =0.01), midline shift >5 mm (OR 18.23, p<0.007) were significantly associated with death. The nomogram’s sensitivity, specificity, PPV, NPV, and AUC for predicting mortality (total score ≥ 100) were 80%, 92.6%, 72.7%, 95.0%, and, 0.86 respectively. Conclusions:PTBI is the fatal injury depend on both clinical and neuroimaging parameters. The nomogram is the alternative method providing prognostic parameters toward implication for clinical decision making.

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Impact of Road Traffic Injury to Pediatric Traumatic Brain Injury in Southern Thailand

Cited by 23 publications

References 20 publications

Predictive Risk Factors for Early Seizures in Traumatic Brain Injury

Predictive Risk Factors for Early Seizures in Traumatic Brain Injury

Blast-induced traumatic brain injury: the experience from a level I trauma center in southern Thailand

Development and Validation of a Nomogram for Predicting the Mortality after Penetrating Traumatic Brain Injury

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