Predictors of In-Hospital Mortality for School-Aged Children with Severe Traumatic Brain Injury.

Chih-Chi Chen,Chih-Chi Chen,Chia-Ying Chung,Chia-Ying Chung,Carl P C Chen,Carl P C Chen,Chien-Hung Chen,Chien-Hung Chen,Chien-Hung Liao,Chien-Hung Liao,Yu-Wei Hsieh,Yu-Wei Hsieh

doi:10.3390/brainsci11020136

Chih-Chi Chen, Chih-Chi Chen + Show 10 more

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https://doi.org/10.3390/brainsci11020136

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Abstract

Traumatic brain injury (TBI) is the leading cause of mortality in children. There are few studies focused on school-aged children with TBI. We conducted this study to identify the early predictors of in-hospital mortality in school-aged children with severe TBI. In this 10 year observational cohort study, a total of 550 children aged 7–18 years with TBI were enrolled. Compared with mild/moderate TBI, children with severe TBI were older; more commonly had injury mechanisms of traffic accidents; and more neuroimage findings of subarachnoid hemorrhage (SAH), subdural hemorrhage (SDH), parenchymal hemorrhage, cerebral edema, and less epidural hemorrhage (EDH). The in-hospital mortality rate of children with severe TBI in our study was 23%. Multivariate analysis showed that falls, being struck by objects, motor component of Glasgow coma scale (mGCS), early coagulopathy, and SAH were independent predictors of in-hospital mortality. We concluded that school-aged children with severe TBI had a high mortality rate. Clinical characteristics including injury mechanisms of falls and being struck, a lower initial mGCS, early coagulopathy, and SAH are predictive of in-hospital mortality.

Highlights

Published: 21 January 2021Traumatic brain injury (TBI) is among the leading causes of mortality and morbidity in children and is an important global health concern [1,2,3,4]
A recent study suggested that age less than 2 years was an independent predictor of mortality in severe head trauma patients [11]
This study identifies the predictors of mortality in school-aged children with severe

Summary

Introduction

Traumatic brain injury (TBI) is among the leading causes of mortality and morbidity in children and is an important global health concern [1,2,3,4]. Mortality rate has been reported from 9% to. 25% in severe pediatric TBI [6]. Pediatric TBI covers a wide range of age groups with different mechanisms of injury and mortality rate [7]. Abusive trauma is common in children less than two years old [8]. Children younger than four years old had the highest fall-related head injury rate. Mortality rate was different in various age groups. A recent study suggested that age less than 2 years was an independent predictor of mortality in severe head trauma patients [11]

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