Abstract
Introduction Severe pediatric traumatic brain injury (pTBI) is a leading cause of disability and death in children worldwide. Children victims of pTBI are admitted to the Sylvanus Olympio University Hospital (SOUH) at the multipurpose Intensive Care Unit (ICU). We aimed in this study to describe the epidemiologic characteristics and outcomes of pTBI patients admitted in this ICU. Patients and Methods This study was conducted at the ICU of SOUH of Lome. It was a retrospective study based on patients' records from 0 to 15 years old admitted during the period from 1 January 2012 to 30 June 2018 (5 years and 6 months). Results We recorded 91 pTBI included in the study. The mean age was 7.7 ± 4.3 years. The male predominated with 67.0%. Road traffic accidents were the most common cause (79.1%), followed by falls (19.8%). The average pediatric Glasgow Coma Scale (pGCS) was 6.6 ± 1.4, with a mean Injury Severity Score (ISS) of 23.1 ± 8.4. The most common brain injuries found in the CT scan were brain edema (72.9%), skull fracture (69.5%), and brain contusion (55.9%). The average duration under mechanical ventilation was 2.1 ± 2.9 days, and the mean ICU stay was 4.9 ± 4.4 days. Overall mortality was 31.9% (29 cases). Factors significantly associated (p < 0.05) with death were hypotension (51.7%), anemia (43.1%), hyperthermia (46.7%), GCS < 6 (64%), and ISS > 20 (48.9%). Conclusion pTBI mortality remains high in SOUH ICU. Factors associated with mortality were secondary systemic insults, worse GCS < 6, and ISS > 20.
Highlights
Severe pediatric traumatic brain injury is a leading cause of disability and death in children worldwide
In Lome (Togo), there are neither trauma centers nor pediatric intensive care units and children with severe TBI are admitted to the multipurpose Intensive Care Unit (ICU) of the Sylvanus Olympio University Hospital (SOUH)
998 severe TBI patients were admitted to the ICU of SOUH
Summary
Severe pediatric traumatic brain injury (pTBI) is a major public health problem and a leading cause of death and disability [1,2,3,4]. pTBI is in the foreground and presents in 80 to 90% of the severe traumas of the child and their management alone determines vital and functional prognosis [4]. Materials and Methods is study was conducted at the multipurpose ICU of SOUH It is an all-age 12-bedded ICU with 5 intensive care physicians and 16 nurses, equipped with a mechanical ventilator. Available monitoring in this ICU included noninvasive blood pressure, pulse oximetry, and continuous ECG recording. Anesthesiology Research and Practice pressure monitoring or transcranial Doppler were not available Neuroimaging tests such as CT scan were not always available at the SOUH, and patients were often transported in poor conditions to other hospitals to realize diagnostic imaging. Data collected included patient demographics, cause of injury, means of transportation to the hospital, admission pGCS, Injury Severity Score (ISS), systemic secondary insults at admission, and injuries found at the cerebral CT scan when it was performed.
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
