Prediction of Poor Prognosis After Severe Head Injury in Children Using Logistic Regression

Ichikawa, Rie; Maeda, Yukihiro; Shibuya, Akira; Umesato, Yoshimasa; Kondo, Yoshiaki; Maeda, Takeshi; Yoshino, Atsuo; Takahashi, Shori

doi:10.1097/pec.0000000000001321

Cited by 3 publications

(2 citation statements)

References 30 publications

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“…Such findings are compatible with those of Gerlach's study, which followed 39 consecutive children and adolescents and found that EDH was associated with a good outcome [49]. The better outcome was related to the rarity of EDH being associated with intracranial injury and the early diagnosis and initiation of appropriate treatment [50]. Despite its relatively better outcome, EDH is still potentially life-threatening, with a reported mortality rate of up to 4.8% in young children [26].…”

Section: Discussionsupporting

confidence: 87%

Predictors of In-Hospital Mortality for School-Aged Children with Severe Traumatic Brain Injury

Chen

et al. 2021

Brain Sciences

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Traumatic brain injury (TBI) is the leading cause of mortality in children. There are few studies focused on school-aged children with TBI. We conducted this study to identify the early predictors of in-hospital mortality in school-aged children with severe TBI. In this 10 year observational cohort study, a total of 550 children aged 7–18 years with TBI were enrolled. Compared with mild/moderate TBI, children with severe TBI were older; more commonly had injury mechanisms of traffic accidents; and more neuroimage findings of subarachnoid hemorrhage (SAH), subdural hemorrhage (SDH), parenchymal hemorrhage, cerebral edema, and less epidural hemorrhage (EDH). The in-hospital mortality rate of children with severe TBI in our study was 23%. Multivariate analysis showed that falls, being struck by objects, motor component of Glasgow coma scale (mGCS), early coagulopathy, and SAH were independent predictors of in-hospital mortality. We concluded that school-aged children with severe TBI had a high mortality rate. Clinical characteristics including injury mechanisms of falls and being struck, a lower initial mGCS, early coagulopathy, and SAH are predictive of in-hospital mortality.

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Section: Discussionsupporting

confidence: 87%

Predictors of In-Hospital Mortality for School-Aged Children with Severe Traumatic Brain Injury

Chen

et al. 2021

Brain Sciences

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“…In addition to our previous approach to establish the prediction model for severe head injury in Japanese children [25], the present external validation of the TRISS, CRASH, and IMPACT models has clarified their value for use in Japan.…”

Section: Discussionmentioning

confidence: 83%

External validation of the TRISS, CRASH, and IMPACT prognostic models in severe traumatic brain injury in Japan

et al. 2019

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In Japan, a range of patients with traumatic brain injury (TBI) has been recorded in a nationwide database (Japan Neurotrauma Data Bank; JNTDB). This study aimed to externally validate three international prediction models using JNTDB data: Trauma and Injury Severity Score (TRISS), Corticosteroid Randomization After Significant Head Injury (CRASH), and International Mission for Prognosis and Analysis of Clinical Trials in TBI (IMPACT). We also aimed to validate the applicability of these models in the Japanese population. Of 1,091 patients registered in the JNTDB from July 2009 to June 2011, we analyzed data for 635 patients. We examined factors associated with mortality in-hospital and unfavorable outcomes 6 months after TBI by applying the TRISS, CRASH, and IMPACT models. We also conducted an external validation of these models based on these data. The patients’ mean age was 60.1 ±21.1 years, and 342 were alive at the time of discharge (53.9%). Univariate analysis revealed eight major risk factors for mortality in-hospital: age, Glasgow Coma Scale (GCS), Injury Severity Score (ISS), systolic blood pressure, heart rate, mydriasis, acute epidural hematoma (AEDH), and traumatic subarachnoid hemorrhage. A similar analysis identified five risk factors for unfavorable outcomes at 6 months: age, GCS, ISS, mydriasis, and AEDH. For mortality in-hospital, the TRISS had a satisfactory area under the curve value (0.75). For unfavorable outcomes at 6 months, the CRASH (basic and computed tomography) and IMPACT (core and core extended) models had satisfactory area under the curve values (0.86, 0.86, 0.81, and 0.85, respectively). The TRISS, CRASH, and IMPACT models were suitable for application to the JNTDB population, indicating these models had high value in Japanese patients with neurotrauma.

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The prevalence of head and facial injuries among children in Saudi Arabia following road traffic crashes

et al. 2020

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BACKGROUND: Motor vehicle crashes (MVCs) are the leading cause of death among children in Saudi Arabia. Childhood injuries can be prevented or minimized if safety measures, such as car seats, are implemented. The literature on the epidemiology of head and facial injury among children is limited, which affects the ability to understand the extent of the burden and hinders investment in public health prevention. OBJECTIVE: Describe the epidemiology of head and facial injuries among children admitted to the hospital following MVCs. DESIGN: Retrospective chart review. SETTING: Five hospitals in several regions. PATIENTS AND METHODS: We collected data on all patients ≤16 years old, who were admitted to the hospital following MVCs between 2016-2019. Differences in various characteristics like head injury status and age groups were compared. MAIN OUTCOME MEASURES: Head and facial injuries. SAMPLE SIZE: 253 patients. RESULTS: Of the injured population, 97 (38.3%) sustained a head injury, and 88 (34.8%) had a facial injury. Thirteen (9.1%) children were driving the car at the time of the crash. About half of the children were seated in the back (53.8%) without a seatbelt or safety seat. CONCLUSION: The prevalence of head and facial injuries is striking. In addition, the study revealed that driving among children is not uncommon, which warrants monitoring and implementing interventions. Improved documentation of restraint use and police enforcement of safety laws can play a significant role in reducing associated injuries. The study findings highlight the importance of combination or rear seating as well as age-appropriate restraint in order to reduce the likelihood of head or facial injuries among children. LIMITATIONS: Retrospective study using the electronic search system to identify patients, but may have missed cases that were not coded correctly. Large amount of missing data for some variables. Additionally, the analysis was limited to those admitted to the hospital. CONFLICT OF INTEREST: None.

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Prediction of Poor Prognosis After Severe Head Injury in Children Using Logistic Regression

Abstract: Using these predictors, subsequent exacerbation may be predicted just after arrival at the hospital and appropriate treatment can be provided immediately.

Cited by 3 publications

References 30 publications

Predictors of In-Hospital Mortality for School-Aged Children with Severe Traumatic Brain Injury

Predictors of In-Hospital Mortality for School-Aged Children with Severe Traumatic Brain Injury

External validation of the TRISS, CRASH, and IMPACT prognostic models in severe traumatic brain injury in Japan

The prevalence of head and facial injuries among children in Saudi Arabia following road traffic crashes

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