Isolated traumatic head injury in children: Analysis of 276 observations

• Main Authors: Bahloul Mabrouk, Chelly Hedi, Chaari Anis, Chabchoub Imen, Haddar Sondes, Herguefi Leila, Dammak Hassen, Hamida Chokri, Ksibi Hichem, Kallel Hatem, Rekik Noureddine, Bouaziz Mounir
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2011-01-01
• Series: Journal of Emergencies, Trauma and Shock
• Subjects: Acute head injury; children; intensive care unit; motor-vehicle crash; prognosis; trauma
• Online Access: http://www.onlinejets.org/article.asp?issn=0974-2700;year=2011;volume=4;issue=1;spage=29;epage=36;aulast=Bahloul
• ISSN: 0974-2700; 0974-519X

<b>Background</b> : To determine predictive factors of mortality among children after isolated traumatic brain injury. <b>Materials and Methods</b> : In this retrospective study, we included all consecutive children with isolated traumatic brain injury admitted to the 22-bed intensive care unit (ICU) of Habib Bourguiba University Hospital (Sfax, Tunisia). Basic demographic, clinical, biochemical, and radiological data were recorded on admission and during ICU stay. <b>Results</b> : There were 276 patients with 196 boys (71&#x0025;) and 80 girls, with a mean age of 6.7 &#177; 3.8 years. The main cause of trauma was road traffic accident (58.3&#x0025;). Mean Glasgow Coma Scale score was 8 &#177; 2, Mean Injury Severity Score (ISS) was 23.3 &#177; 5.9, Mean Pediatric Trauma Score (PTS) was 4.8 &#177; 2.3, and Mean Pediatric Risk of Mortality (PRISM) was 10.8 &#177; 8. A total of 259 children required mechanical ventilation. Forty-eight children (17.4&#x0025;) died. Multivariate analysis showed that factors associated with a poor prognosis were PRISM &gt; 24 (OR: 10.98), neurovegetative disorder (OR: 7.1), meningeal hemorrhage (OR: 2.74), and lesion type VI according to Marshall tomographic grading (OR: 13.26). <b>Conclusion</b> : In Tunisia, head injury is a frequent cause of hospital admission and is most often due to road traffic injuries. Short-term prognosis is influenced by demographic, clinical, radiological, and biochemical factors. The need to put preventive measures in place is underscored.