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. 2011 Jan;4(1):29-36.
doi: 10.4103/0974-2700.76831.

Isolated traumatic head injury in children: Analysis of 276 observations

Mabrouk Bahloul  1 , Hedi Chelly, Anis Chaari, Imen Chabchoub, Sondes Haddar, Leila Herguefi, Hassen Dammak, Chokri Ben Hamida, Hichem Ksibi, Hatem Kallel, Noureddine Rekik, Mounir Bouaziz
Affiliations

Isolated traumatic head injury in children: Analysis of 276 observations

Mabrouk Bahloul et al. J Emerg Trauma Shock. 2011 Jan.

Abstract

Background: To determine predictive factors of mortality among children after isolated traumatic brain injury.

Materials and methods: 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.

Results: There were 276 patients with 196 boys (71%) and 80 girls, with a mean age of 6.7 ± 3.8 years. The main cause of trauma was road traffic accident (58.3%). Mean Glasgow Coma Scale score was 8 ± 2, Mean Injury Severity Score (ISS) was 23.3 ± 5.9, Mean Pediatric Trauma Score (PTS) was 4.8 ± 2.3, and Mean Pediatric Risk of Mortality (PRISM) was 10.8 ± 8. A total of 259 children required mechanical ventilation. Forty-eight children (17.4%) died. Multivariate analysis showed that factors associated with a poor prognosis were PRISM > 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).

Conclusion: 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.

Keywords: Acute head injury; children; intensive care unit; motor-vehicle crash; prognosis; trauma.

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Conflict of interest statement

Conflict of Interest: None declared

Figures

Figure 1
Figure 1
Cause of head trauma in each age groups
Figure 2
Figure 2
Mortality rate correlated with Glasgow Coma Scale Score
Figure 3
Figure 3
Roc curve for ability of PRISM score to predict mortality
Figure 4
Figure 4
Mortality rate according to “Traumatic Coma Data Bank” classification
Figure 5
Figure 5
Association between mortality and the number of developed secondary systemic insults (SSI)
See this image and copyright information in PMC

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