Related Experiment Video
Updated: Jun 2, 2026
A Pediatric Concussion Model in Mice: Closed Head Injury with Long-Term Disorders (CHILD)
Published on: February 7, 2025
Traumatic brain injury in pediatric age group; predictors of outcome in Pediatric Intensive Care Unit
Hm Kamal1, Aa Mardini, Bokhary Mm Aly
1Pediatric and Neurosurgery Departments, King Fahad Hofuf Hospital, KSA.
Insights
Predictors for pediatric traumatic brain injury (TBI) outcomes were identified. Glasgow Coma Scale, CT scans, hypotension, and lab values significantly indicate survival and neurological deficits in children after TBI.
Area of Science:
- Pediatric Intensive Care
- Neurology
- Trauma Surgery
Background:
- Traumatic brain injury (TBI) is a significant cause of mortality and morbidity in children.
- Predicting outcomes in pediatric TBI is crucial for effective management and resource allocation.
Purpose of the Study:
- To identify key predictors of mortality and neurological deficits in children under twelve years old following TBI.
- To analyze the association between initial clinical and radiological findings and patient outcomes.
Main Methods:
- Retrospective cohort study of 106 pediatric patients (≤12 years) admitted to a pediatric intensive care unit (PICU).
- Data collected included initial Glasgow Coma Scale (GCS), brain CT findings, presence of hypotension, need for mechanical ventilation, liver enzymes, and serum albumin levels.
- Patients were categorized into deaths, survivors with neurological deficits (ND), and survivors with no neurological deficits (NND).
Main Results:
- Lower initial GCS scores (≤4) were strongly associated with mortality.
- Abnormal brain CT findings and combined brain pathologies were prevalent in non-survivors and those with neurological deficits.
- Hypotension, high liver enzymes, and low serum albumin levels were significantly more common in patients with adverse outcomes (death or ND).
Conclusions:
- Initial Glasgow Coma Scale, brain CT findings, and combined brain pathologies are critical predictors of TBI outcomes in children.
- Hemodynamic instability (hypotension), elevated liver enzymes, and hypoalbuminemia are significant indicators of poor prognosis in pediatric TBI.
- These factors can aid in early risk stratification and management of pediatric TBI patients.
Objective:
To determine predictors for outcomes of traumatic brain injury (TBI) in infants and children younger than twelve years admitted to our pediatric intensive care units (PICU).
Methods:
This is a retrospective cohort study from 2004-5, done at the PICU of King Fahad Hofuf Hospital, Eastern Province, Saudi Arabia. One hundred and six patients with TBI; 65 boys and 41 girls ages 12 or under, with a mean age of 5.7 years, were included. Of them, 11.3% died (Deaths group), 11% survived with neurological deficits (NDgroup), and 77% survived with no neurological deficits (NND-group). The potential predictors for death or neurological deficits were examined.
Results:
83% of deaths had initial Glascow coma scale (GCS) of ≤ 4/15, 50% of ND had initial GCS ≤8 and 27% of NND had GCS < 12. The initial brain CT was abnormal in 92% of deaths and ND groups, but in only 37% of NND. Combined brain pathologies were found in 92% of deaths, 63% of ND and only in 5% of NND. Hypotension was seen in 67% of deaths, 17% ND and only in 1% of NND. Mechanical ventilation was required in all deaths and more than half of ND. Liver enzymes were high in 50% of deaths and 66% of ND but in only 20% of NND. Serum albumin was low in 33% of deaths, 42% of ND and only 1% NND.
Conclusion:
Glasgow coma score, brain CT findings, combined brain pathologies, hypotension, high liver enzymes and low serum albumin predict outcome after TBI in pediatric age group.
