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Correlation Between Clinical Findings at Admission and Glasgow Outcome Scale Score in Children with Traumatic Brain
Amir Rezakhah1, Andrew J Kobets2, Faezeh Emami Sigaroudi3
1Department of Neurosurgery, Urmia University of Medical Sciences, Urmia, Iran.
Insights
Clinical and lab findings at admission significantly impact pediatric traumatic brain injury outcomes. Factors like hypotension, hyponatremia, and pupil response predict the Glasgow Outcome Scale (GOS) score.
Area of Science:
- Pediatric neurosurgery
- Traumatology
- Clinical neurology
Background:
- Traumatic brain injury (TBI) presents unique challenges in pediatric populations.
- Understanding factors influencing TBI outcomes in children is crucial for effective management.
Purpose of the Study:
- To investigate the correlation between initial clinical and laboratory findings and the Glasgow Outcome Scale (GOS) score in pediatric TBI patients.
Main Methods:
- A prospective, cross-sectional study involving 444 children (ages 1-16) with TBI.
- Data on clinical presentation and laboratory results at admission were collected.
- The relationship between these findings and GOS scores at discharge was analyzed.
Main Results:
- No significant correlation was found between GOS score and sex, age, serum potassium, platelet count, or blood glucose.
- Significant associations were observed between GOS score and hypotension, hyponatremia, prothrombin time, partial thromboplastin time, pupil size, pupil reaction to light, and Glasgow Coma Scale score.
Conclusions:
- Initial clinical indicators like hypotension, hyponatremia, and pupil abnormalities are critical predictors of TBI outcomes in children.
- Specific laboratory values and neurological signs at admission can significantly influence the discharge GOS score and prognosis.
Objective:
Traumatic brain injury has different pathophysiology and outcomes in children and adults. This study investigated the relationship between clinical and laboratory findings at admission and Glasgow Outcome Scale (GOS) score in children with traumatic brain injury.
Methods:
This prospective cross-sectional single-center study enrolled 444 children 1-16 years old admitted to the neurosurgery ward from 2016 to 2020. Clinical data and laboratory information were extracted from the records of these patients at admission, and the relationship with GOS score at discharge was investigated.
Results:
The 444 patients include 249 (56.08%) boys and 195 (43.92%) girls with a mean age of 7.32 ± 4.4 years. There was no correlation between GOS score and sex (P = 0.12), age (P = 0.16), serum potassium level (P = 0.08), platelet level (P = 0.21), and blood glucose (P = 0.18). There was a significant relationship between GOS score and hypotension (P = 0.03), hyponatremia (P = 0.04), prothrombin time (P = 0.03), partial thromboplastin time (P = 0.03), pupil size (P = 0.02), pupil reaction to light (P = 0.04), and Glasgow Coma Scale score (P = 0.04).
Conclusions:
Clinical and laboratory findings such as hypotension, hyponatremia, prothrombin time, partial thromboplastin time, pupil size, pupil reaction to light, and Glasgow Coma Scale score at admission could affect GOS score at discharge and result in poor outcomes in children with traumatic brain injury.
