Prognostic Value of Leukocytosis in Pediatric Head Trauma

Abstract

Introduction: The most common cause of the morbidity and mortality in the childhood period age group is head traumas. In emergency departments computed tomography (CT) for diagnostic purposes is used more frequently in head traumas that are occurred in pediatric patients than in adults. Different protocols have been defined for brain CT in children with head trauma, clinical evaluations come to the fore in these protocols; however, there is no biomarker. Objective: Our aim in this study is to investigate the relationship between age, gender, trauma etiology, presence of symptoms at the time of admission, Glasgow Coma Scale (GCS), brain CT findings and blood WBC levels at admission. Method: 305 pediatric patients [between 0 and 18 years old] who applied to the emergency department of Kafkas University Medical Faculty Hospital between 2016 and 2019 after head trauma were included in the study. The data of these patients were analyzed retrospectively from the hospital records. Age, gender, head trauma etiology, GCS scores at the time of presentation, their symptoms, their brain CT findings and blood WBC levels were examined. Chi-square test was performed between patients with and without leukocytosis and independent variables. Results: After applying exclusion factors, the data of 173 patients who underwent CT in the emergency room after head trauma and whose blood tests were studied were examined. When patients were analyzed according to gender, 111 (64.2%) were male and 62 (35.8%) were found to be female. In terms of age, it was seen that those between the ages of 0 and 2 were 54 (31.2%), and those between the ages of 2- and 18 were 119 (68.8%). Among the etiological causes of traumas, the most frequent (n = 113) 65.3% falls were seen. The number of patients with symptoms was 57 (32.9%). Patients with GCS 14 ≥ constituted 69.4% of the total patients (n = 120). There was a pathological finding in 19.0% of the brain CT' s (n = 33) taken. Leukocytosis was detected in 17.3% of the patients [n = 30]. Conclusion: As a result of this study, it was found statistically significant that the blood WBC levels were higher in children who had head trauma, whose GCS was 13 ≤ at the time of application, who had symptoms and who had pathology in brain CT compared to other groups.