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Prediction of mortality in pediatric traumatic brain injury: Implementations from a tertiary pediatric intensive care

Ebru Atike Ongun1, Oğuz Dursun

  • 1Department of Pediatric Critical Care, Akdeniz University Faculty of Medicine, Antalya-Turkey. ebruongun@akdeniz.edu.tr.

Ulusal Travma Ve Acil Cerrahi Dergisi = Turkish Journal of Trauma & Emergency Surgery : TJTES
|May 23, 2018
PubMed

Insights

Traumatic brain injury (TBI) in children admitted to the pediatric intensive care unit has a 12.5% mortality rate. The Rotterdam-CT score is an independent risk factor for mortality in pediatric TBI.

Area of Science:

  • Pediatric intensive care
  • Neurotrauma
  • Critical care medicine

Background:

  • Traumatic brain injury (TBI) is a significant cause of mortality in children.
  • Identifying risk factors for TBI mortality in pediatric intensive care units (PICUs) is crucial for improving patient outcomes.

Purpose of the Study:

  • To investigate the mortality risk factors associated with traumatic brain injury in pediatric intensive care unit admissions.
  • To identify predictors of mortality in pediatric TBI patients.

Main Methods:

  • Analysis of 88 pediatric patients admitted to the PICU with TBI between September 2014 and December 2016.
  • Data collected included Glasgow Coma Scale, emergency department and ICU course, treatment strategies, axonal injury, intubation/tracheostomy rates, length of stay, Rotterdam-CT scores, Injury Severity Score (ISS), and Pediatric Risk of Mortality (PRISM-III) scores.

Main Results:

  • Older age was associated with trauma severity (p=0.010).
  • Axonal injury correlated with prolonged intubation, ICU, and hospital stay (p<0.001).
  • Six children required tracheostomy, with five decannulated within 6 months.

Conclusions:

  • The overall mortality rate was 12.5%, with six patients progressing to brain death.
  • Initial hypotension, lung contusion, ISS, and Rotterdam-CT scores were associated with mortality.
  • The Rotterdam-CT score emerged as an independent risk factor for mortality, increasing the odds of recovery by 20.334 times (95% CI 1.999-206.879).
Abstract

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