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A Novel Model of Mild Traumatic Brain Injury for Juvenile Rats
Published on: December 8, 2014
A novel predictor of mortality for penetrating brain injury in paediatric patients
Mustafa Bolatkale1, Kursat Kaan Kerimoglu2, Yahya Efe Guner3
1Mustafa Bolatkale, MD, Associate Professor, Department of Emergency Medicine, Alsancak Nevvar-Salih Isgoren State Hospital, Konak, Izmir, Turkiye.
Insights
In children with penetrating brain injury (PBI), having two or more intracranial foreign bodies (FBs) significantly increases mortality risk. This count of FBs may serve as a novel prognostic factor for PBI outcomes.
Area of Science:
- Neurosurgery
- Pediatric Traumatology
- Emergency Medicine
Background:
- Penetrating brain injury (PBI) in children carries a high mortality rate.
- Predictors of mortality in pediatric PBI are not well-established.
- Identifying accessible prognostic factors is crucial for managing these severe injuries.
Purpose of the Study:
- To investigate the association between the number of intracranial foreign bodies (FBs) and mortality in pediatric PBI patients.
- To evaluate the role of brain computed tomography (CT) findings in predicting outcomes.
- To identify key mortality predictors in children with PBI presenting to the emergency department (ED).
Main Methods:
- Prospective observational study conducted in an ED from December 2015 to December 2022.
- Included pediatric patients with isolated penetrating head injuries from ballistic or explosive trauma.
- Collected data on demographics, pre-hospital care, Glasgow Coma Scale (GCS) scores, CT findings, and mortality.
Main Results:
- A total of 126 pediatric PBI patients were analyzed.
- The presence of ≥2 intracranial FBs was a significant predictor of increased mortality (OR 37.4, p<0.001).
- Other significant predictors included low GCS score (≤9), epidural hematoma, midline shift, and pre-hospital intubation.
Conclusions:
- Having ≥2 intracranial FBs is strongly associated with increased mortality in pediatric PBI.
- The count of intracranial FBs presents a potential novel and accessible prognostic factor.
- Further validation is needed to integrate FB count into clinical decision-making for pediatric PBI.
Objective:
Penetrating brain injury (PBI) is a severe form of traumatic brain injury associated with high mortality, particularly in children. However, mortality predictors in children with PBI remain unclear. This study aimed to evaluate the association among the number of intracranial foreign bodies (FBs), brain computed tomography (CT) findings, and mortality outcomes in paediatric patients with PBI who presented to the emergency department (ED).
Methodology:
This prospective observational study was conducted in the ED of Kilis State Hospital from December 2015 to December 2022. Paediatric patients with isolated penetrating head injuries from sniper gunshot wounds or barrel bomb explosions were included. Demographic data, pre-hospital interventions, Glasgow Coma Scale scores, brain CT findings, and mortality outcomes were collected and analysed.
Results:
This study included 126 paediatric patients with PBI. The presence of ≥2 intracranial FBs was significantly associated with increased mortality (odds ratio 37.4; p<0.001). Other mortality predictors included Glasgow Coma Scale score ≤9, epidural haematoma, midline shift, and pre-hospital endotracheal intubation. Mortality was not significantly different between injuries from shrapnel and those from sniper gunshots.
Conclusion:
In paediatric patients with PBI, having ≥2 intracranial FBs was associated with increased mortality. Therefore, FB count may be a novel and accessible prognostic factor. Further research is required to validate these findings and support their integration into clinical decision-making.
