دورية أكاديمية
أعرض في EDS

The role of coagulopathy on clinical outcome following traumatic brain injury in children: analysis of 66 consecutive cases in a single center institution.

التفاصيل البيبلوغرافية
العنوان: The role of coagulopathy on clinical outcome following traumatic brain injury in children: analysis of 66 consecutive cases in a single center institution.
المؤلفون: Podolsky-Gondim GG; Division of Pediatric Neurosurgery, Department of Surgery and Anatomy, University Hospital, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, 14049-900, Brazil., Furlanetti LL; Department of Neurosurgery, University of Saarland, Homburg, Germany., Viana DC; Division of Pediatric Neurosurgery, Department of Surgery and Anatomy, University Hospital, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, 14049-900, Brazil., Ballestero MFM; Division of Pediatric Neurosurgery, Department of Surgery and Anatomy, University Hospital, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, 14049-900, Brazil., de Oliveira RS; Division of Pediatric Neurosurgery, Department of Surgery and Anatomy, University Hospital, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, 14049-900, Brazil. rsoliveira30@gmail.com.
المصدر: Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery [Childs Nerv Syst] 2018 Dec; Vol. 34 (12), pp. 2455-2461. Date of Electronic Publication: 2018 Oct 18.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Springer International Country of Publication: Germany NLM ID: 8503227 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1433-0350 (Electronic) Linking ISSN: 02567040 NLM ISO Abbreviation: Childs Nerv Syst Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Berlin : Springer International, c1985-
مواضيع طبية MeSH: Recovery of Function*, Blood Coagulation Disorders/*etiology , Brain Injuries, Traumatic/*complications, Adolescent ; Blood Coagulation Disorders/epidemiology ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Prognosis ; Retrospective Studies
مستخلص: Introduction: Head injury is a significant economic, social, and medical problem in developing countries and remains one of the leading causes of pediatric morbidity and mortality. The association of traumatic brain injury and coagulopathy in children is linked with an increase in mortality and poor functional outcomes. However, its impact on long-term outcome has not been discussed in the literature so far.
Objectives: The aim of this paper was to investigate the effect of coagulopathy diagnosed by routine laboratory tests on neurological outcome following traumatic brain injury in children.
Methods: A retrospective review was carried out using medical records of children with a traumatic brain injury admitted at a level I trauma center, between January 2013 and December 2016, submitted to any neurosurgical procedures. Statistical analysis was performed accordingly to identify factors predicting unfavorable or favorable outcomes at 1- and 6-month follow-ups. Data regarding age, gender, trauma mechanism, Glasgow Coma Scale at admission and at discharge, highest and lowest stable intracranial pressure, serum glucose and coagulation assessment, radiological findings, and length of stay were analyzed.
Results: We identified 66 children with surgical head trauma. Mean age was 10.9 years (ranges from 3 months to 17 years), with male predominance (77.3%). Common mechanisms were road traffic accidents (66.7%), falls (19.7%), and blunt trauma (10.6%). Brain edema was detected in 68.2% of the patients, surgical fractures or intracranial bleeding in 75.8%. ICP monitoring was performed in 24.2% of the patients, and of these, 18.7% underwent consecutive decompressive craniectomy. Mean length of in-patient treatment was 16.3 ± 28.2 days. At 1- and 6-month follow-ups, favorable outcome was detected in 71.2 and 78.7% of the patients, respectively. The mortality rate was 12.1%. Routine coagulation assessments such as prothrombin time, fibrinogen levels, and thrombocyte count upon admission were potential prognostic variables identified.
Conclusions: The present study concluded that a trauma-related coagulopathy is an important predictor of unfavorable neurological outcome following TBI in pediatric patients. Initial GCS score, age, and neuroradiological findings, such as severe brain edema and different types of intracranial bleeding, correlated with GOS in the first 6 months following TBI. Sustained intracranial hypertension also predicted unfavorable outcome and death in this series.
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فهرسة مساهمة: Keywords: Brain injury; Head trauma; Pediatric neurosurgery; Traumatic brain injury
تواريخ الأحداث: Date Created: 20181019 Date Completed: 20191115 Latest Revision: 20191115
رمز التحديث: 20221213
DOI: 10.1007/s00381-018-3989-1
PMID: 30334071
قاعدة البيانات: MEDLINE
الوصف
تدمد:1433-0350
DOI:10.1007/s00381-018-3989-1