Yield of Leukocytosis in Predicting Brain Computed Tomography Pathological Findings in Pediatric Patients with Head Traumatic Injuries

Abstract

BBackground: Head trauma is an urgent medical condition that is prevalent in pediatric patients. The association between white blood cell (WBC) counts and their prognostic value in pediatric traumatic brain injury has been proposed in multiple studies. Hence, WBC count can be used to determine the presence of traumatic brain injury. Thus, we aimed to address this gap by assessing the value of WBC count in predicting pathological CT findings in pediatric patients with traumatic head injuries. Methods: This retrospective cohort study included 108 patients with isolated head trauma aged 0–14 years who underwent brain CT examination and had available data on WBC count upon presentation to the emergency room. Chi-square and Fisher's exact tests were used to determine the statistical significance. Logistic regression analysis was performed to further explore the relationships between the variables. Results: Falls were the most common cause of head trauma (88 [81.48%] patients). Leukocytosis was reported in 35 (32.41%) patients and non-leukocytosis in 73 (67.59%) patients. Sixty-four patients (59.26%) had pathological brain CT findings, whereas 44 (40.74 %) had non-pathological findings. The leukocytosis status differed (odds ratio [OR]=0.99, 95% confidence interval [CI]=2.55–0.38; P= 0.9839) according to the pathological CT findings, but the difference was not significant. Age (0–2 years) and Glasgow Coma Scale score (≤14) were significant predictors of pathological brain CT findings (OR=3.79, 95% CI=9.24–1.55, P=0.0033 and OR=14.04, 95% CI=127.59–1.54, P=0.0189, respectively). Conclusion: The presence of leukocytosis is useful for predicting pathological brain scan findings. Therefore, further multicenter studies with a larger sample size are warranted to determine the benefits of WBC count in patients with head trauma.