Abstract P-520: PHYSIOLOGIC RISK FACTORS ASSOCIATED WITH FUNCTIONAL OUTCOMES IN PEDIATRIC POST-TRAUMATIC CEREBRAL VASOSPASM

Abstract

Aims & Objectives: This study examined the physiologic risk factors associated with post-traumatic cerebral vasospasm and poor outcome in children with acute traumatic brain injury. Methods Prospective single center study of previously health (N=60) children ages 5 days to 15 years of age admitted to hospital for an acute TBI. Data include physiologic (temperature, blood pressure, intracranial pressure, serum glucose) data, seizure and CV activity and genetic sampling over 8 days of hospitalization. Functional outcomes were measured at discharge and at 4-week follow-up using the Glasgow Outcome Scale-Extended, Pediatrics (GOS-E Peds). Results Our study included 26 females (43%) and 34 males (57%) with a mean age was 5.9 years, of which 43% of participants experienced an occurrence of CV (anterior or posterior). A total of 62 CV events were identified (Table 1) with subarachnoid hemorrhage being the most prevalent lesion. CV occurred within the first 48 hours of hospitalization. CV was associated with the number of seizures (p-value = 0.042) when adjusted for injury severity. In addition, CV in the anterior circulation was associated with occurrences of hypotension (p-value = 0.016) and hypothermia (p-value = 0.028). The presence of a physiologic instability also showed proportionally poorer GOS-E eds outcomes at both measurement time points. Conclusions We identified that physiologic instability was associated with post-traumatic CV and poorer outcomes in our TBI patients. Although more research is needed to better define these relationships, clinically the opportunity to improve outcomes in patients with TBI should include the evaluation for post-traumatic CV and management of physiologic instability.