The Influence of Serious Extracranial Injury on In-Hospital Mortality in Children with Severe Traumatic Brain Injury

(1) Background: Severe traumatic brain injury (sTBI) is the leading cause of death in children. Serious extracranial injury (SEI) commonly coexists with sTBI after the high impact of trauma. Limited studies evaluate the influence of SEI on the prognosis of pediatric sTBI. We aimed to analyze SEI’s c...

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Bibliographic Details
Main Authors: Chao, M. (Author), Chen, C.-C (Author), Chen, C.P.C (Author), Chung, C.-Y (Author), Ouyang, C.-H (Author), Wang, C.-C (Author)
Format: Article
Language:English
Published: MDPI 2022
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Online Access:View Fulltext in Publisher
LEADER 02787nam a2200253Ia 4500
001 10.3390-jpm12071075
008 220718s2022 CNT 000 0 und d
020 |a 20754426 (ISSN) 
245 1 0 |a The Influence of Serious Extracranial Injury on In-Hospital Mortality in Children with Severe Traumatic Brain Injury 
260 0 |b MDPI  |c 2022 
856 |z View Fulltext in Publisher  |u https://doi.org/10.3390/jpm12071075 
520 3 |a (1) Background: Severe traumatic brain injury (sTBI) is the leading cause of death in children. Serious extracranial injury (SEI) commonly coexists with sTBI after the high impact of trauma. Limited studies evaluate the influence of SEI on the prognosis of pediatric sTBI. We aimed to analyze SEI’s clinical characteristics and initial presentations and evaluate if SEI is predictive of higher in-hospital mortality in these sTBI children. (2) Methods: In this 11-year-observational cohort study, a total of 148 severe sTBI children were enrolled. We collected patients’ initial data in the emergency department, including gender, age, mechanism of injury, coexisting SEI, motor components of the Glasgow Coma Scale (mGCS) score, body temperature, blood pressure, blood glucose level, initial prothrombin time, and intracranial Rotterdam computed tomography (CT) score of the first brain CT scan, as potential mortality predictors. (3) Results: Compared to sTBI children without SEI, children with SEI were older and more presented with initial hypotension and hypothermia; the initial lab showed more prolonged prothrombin time and a higher in-hospital mortality rate. Multivariate analysis showed that motor components of mGCS, fixed pupil reaction, prolonged prothrombin time, and higher Rotterdam CT score were independent predictors of in-hospital mortality in sTBI children. SEI was not an independent predictor of mortality. (4) Conclusions: sTBI children with SEI had significantly higher in-hospital mortality than those without. SEI was not an independent predictor of mortality in our study. Brain injury intensity and its presentations, including lower mGCS, fixed pupil reaction, higher Rotterdam CT score, and severe injury-induced systemic response, presented as initial prolonged prothrombin time, were independent predictors of in-hospital mortality in these sTBI children. © 2022 by the authors. Licensee MDPI, Basel, Switzerland. 
650 0 4 |a children 
650 0 4 |a mortality 
650 0 4 |a predictors 
650 0 4 |a serious extracranial injury 
650 0 4 |a severe traumatic brain injury 
700 1 |a Chao, M.  |e author 
700 1 |a Chen, C.-C.  |e author 
700 1 |a Chen, C.P.C.  |e author 
700 1 |a Chung, C.-Y.  |e author 
700 1 |a Ouyang, C.-H.  |e author 
700 1 |a Wang, C.-C.  |e author 
773 |t Journal of Personalized Medicine