Post-traumatic early epilepsy in pediatric age group with emphasis on influential factors

Ateş, Özkan; Öndül, Sevim; Önal, Çağatay; Büyükkıraz, Mehmet; Somay, Hakan; Çaylı, Süleyman; Göğüsgeren, Mehmet A.; Orakdogen, Metin; Koçak, Ayhan; Yoloğlu, Saim; Berkman, Zafer; Tevrüz, M.

doi:10.1007/s00381-005-1177-6

Cited by 18 publications

(22 citation statements)

References 29 publications

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“…The incidence of PTS identified in our study, 25.2%, is similar to prior reports of 19–39% among pediatric study populations or subgroups restricted to severe TBI. (9, 14–16) We confirm the most commonly reported risk factors for PTS: young age(5, 9, 12, 14, 16, 17), abusive mechanism(12, 14, 17), and presence of SDH. (5, 12, 14, 17) We also corroborate reports that abusive mechanism and SDH are frequently present simultaneously, particularly in young children.…”

Section: Discussionsupporting

confidence: 81%

“…Specific skull and cerebral imaging findings, such as depressed skull fracture, intraparenchymal hemorrhage, and cerebral edema, have been associated with PTS after pediatric TBI. (4, 16) Unfortunately, our dataset does not allow assessment of these specific imaging findings.…”

Section: Discussionmentioning

confidence: 99%

“…(5, 9, 14, 16, 17) Additionally, based on association with seizures and potential exacerbation of secondary cerebral injury, cardiac arrest, and early hypotension were selected a priori as candidate predictors of PTS. (17) The primary analysis was conducted using generalized estimating equations (GEEs).…”

Section: Methodsmentioning

confidence: 99%

“…(5, 9, 14, 16, 17) Multiple risk factors for PTS are frequently present in combination, making determination of individual contributions to overall risk challenging. This is particularly true among young children injured by abuse/assault because young age, SDH, and abusive mechanism frequently occur simultaneously.…”

Section: Introductionmentioning

confidence: 99%

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Seizures in Children With Severe Traumatic Brain Injury*

Bennett

DeWitt

Harlaar

et al. 2017

Pediatric Critical Care Medicine

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Objective Traumatic brain injury (TBI) causes substantial morbidity and mortality in children. Post-traumatic seizures (PTS) may worsen outcomes after TBI. PTS risk factors are incompletely understood. Our objective was to clarify PTS risk factors in a large cohort of children with severe TBI. Design Retrospective cohort study of a probabilistically linked dataset from the National Trauma Data Bank (NTDB) and the Pediatric Health Information Systems (PHIS) database, 2007–2010 Setting 29 U.S. children’s hospitals Patients 2,122 children (age < 18 years old at admission) with linked NTDB and PHIS records, severe (Emergency Department [ED] Glasgow Coma Scale [GCS] < 8) TBI, hospital length of stay > 24 hours, and non-missing disposition Interventions None Measurements and Main Results The outcome was PTS, identified using validated ICD-9-CM diagnosis codes. Pre-specified candidate predictors of PTS included age, injury mechanism, ED GCS, intracranial hemorrhage type, hypoxia, hypotension, and cardiac arrest. PTS were diagnosed in 25.2% of children with severe TBI. In those without abuse/assault or subdural hemorrhage (SDH), the PTS rate varied between 36.6% in those < 2 years old and 16.4% in those 14–17 years old. Age, abusive mechanism, and subdural hemorrhage (SDH) are each significant predictors of PTS. The risk of PTS has a complex relationship with these predictors. The estimated odds of PTS decrease with advancing age, OR = 0.929 (0.905, 0.954) per additional year of age with no abuse/assault and no SDH; OR = 0.820 (0.730, 0.922) per additional year of age when abuse and SDH are present. An infant with accidental TBI and SDH has approximately the same estimated probability of PTS as an abused infant without SDH, 47% (95% CI: 39%, 55%) versus 50% (95% CI: 41%, 58%), P = 0.69. The triad of young age, injury by abuse/assault, and SDH confers the greatest estimated probability for PTS, 60% (95% CI: 53%, 66%). Conclusions PTS risk in children with severe TBI is greatest with a triad of younger age, injury by abuse/assault, and SDH. However, PTS is common even in the absence of these factors.

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Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Seizures in Children With Severe Traumatic Brain Injury*

Bennett

DeWitt

Harlaar

et al. 2017

Pediatric Critical Care Medicine

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show abstract

“…Traumatic brain injury and post-cardiac arrest encephalopathy have been the two most commonly studied etiologies, with the incidence of early post-traumatic seizures in children ranging between 9%–23% [3–5]. Reported risk factors for early post-traumatic seizures have included younger age, injury severity, and presence of cerebral edema [4]. The variability in the incidence across different studies can be attributed to multiple factors including differences in the age of study populations, variability in the use of seizure prophylaxis, and variability in the frequency and duration of continuous EEG monitoring.…”

mentioning

confidence: 99%