P20.5 Functional outcome of children with severe brain injuries

Abstract

Background Injury is an important factor in childhood morbidity and mortality, with road traffic injuries (RTA) taking the lead. Due to anatomic characteristics, the head is the most frequent site of severe injury in children. The outcome of patients in PICU is significantly dependent on the severity of brain lesion. Aim The aim of this study was to evaluate the functional outcome of patients with injuries treated in pediatric intensive care unit (PICU), with respect to the two important data: the leading injured body region and mechanism of injury. Methods In the period of 2008 to 2009 the data was obtained prospectively and outcome was assessed according to Pediatric Overall Performance Category (POPC) scale for 118 patients in PICU of the University Hospital of Split. Functional performance of patients was assessed as the baseline, pre-admission score (bPOPC) and the discharge functional score (dPOPC) was evaluated before transfer of patients from PICU. Results Head (63.5%) was the most common affected anatomic region, followed by abdomen (15.2%) and limbs (11.0%). The RTA was the leading cause of childhood injury (68%). Deterioration of functional morbidity (ΛP) was worse in children injured in RTA (0.0063) and it was significantly worse children with head injuries (0.0451). Conclusion The outcome expressed with POPC scale is primarily based on neurological functioning. The results of this study point to the importance of prevention of severe brain injury, which is associated with poor long-term outcome of injured children.