Related Experiment Video
Updated: Jun 13, 2026
A Pediatric Concussion Model in Mice: Closed Head Injury with Long-Term Disorders (CHILD)
Published on: February 7, 2025
Initial predictive factors of outcome in severe non-accidental head trauma in children
Didier Scavarda1, Charline Gabaudan, Fabrice Ughetto
1Department of Pediatric Neurosurgery, CHU Timone Enfants, 264 rue Saint Pierre, 13385, Marseille cedex 05, France. didier.scavarda@ap-hm.fr
Insights
This study shows that the Pediatric Risk of Mortality (PRISM) II score accurately predicts outcomes for young children with non-accidental head trauma. Simpler scores like the Glasgow Coma Scale (GCS) and Pediatric Trauma Score (PTS) also offer good survival prediction.
Area of Science:
- Pediatric Critical Care Medicine
- Trauma Surgery
- Neurology
Background:
- Non-accidental head trauma is a significant cause of injury in young children.
- Accurate prognostic scoring is crucial for managing these severe cases.
Purpose of the Study:
- To evaluate outcomes of young children hospitalized for non-accidental head trauma.
- To assess the utility of the PRISM II score in this population.
- To identify factors influencing short-term outcomes.
Main Methods:
- Systematic review of 36 children under 2 years old with non-accidental head trauma over 10 years.
- Collected demographic, clinical, and management data.
- Calculated PRISM II, Glasgow Coma Scale (GCS), and Pediatric Trauma Score (PTS).
- Used univariate and multivariate logistic regression to analyze factors associated with mortality.
Main Results:
- Mortality rate was 27.8%.
- PTS, PRISM II, GCS, PT, PTT, and diabetes insipidus were significantly altered in non-survivors.
- PRISM II cutoff of 17.5 indicated increased mortality risk (sensitivity 0.8, specificity 0.88).
Conclusions:
- PRISM II is a reliable tool for assessing prognosis in young children with non-accidental head trauma.
- GCS and PTS also demonstrated good accuracy in predicting survival.
- These scores aid in managing pediatric trauma patients.
Object:
The aim of this study is to evaluate the outcome of young children hospitalized for non-accidental head trauma in our PICU, to evaluate PRISM II score in this sub-population of pediatric trauma and to identify factors that might influence the short-term outcome.
Materials And Methods:
Files of all children less than 2 years old with the diagnosis of non-accidental head trauma over a 10-years period were systematically reviewed. We collected data on demographic information, medical history, clinical status, and management in the PICU. Three severity scores were then calculated: PRISM II, Glasgow Coma Scale (GCS), and Pediatric Trauma Score (PTS). Prognosis value of qualitative variables was tested with a univariate procedure analysis (anemia, diabetes insipidus...). Then, quantitative variables were tested with univariate procedure too (age, weight, PRISM II, GCS, Platelet count, fibrin, prothrombin time (PT)...). Potential association between variables and death was tested using univariate procedure. Variables identified by univariate analysis were then analyzed with multivariate analysis through a forward-stepping logistic regression.
Results:
Thirty-six children were included. Mean age was 5.5 months (8 days-21.5 months). Mortality rate was 27.8%. At admission, PTS, PRISM II, GCS, PT, PTT, and diabetes insipidus were significantly altered or more frequent in non survivors. Cutoff value for PRISM II at which risk of mortality increased was 17.5 (sensitivity = 0.8; specificity = 0.88).
Conclusion:
PRISM II is a reliable and easy performing tool for assessing the prognosis of non-accidental cranial traumatism in young children. GCS and PTS, scores even simpler than PRISM II, showed good accuracy regarding survival prediction.
