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ANALYSIS OF THE OUTCOMES OF CHILDREN WITH SEVERE TRAUMATIC BRAIN INJURY IN TURKEY- EVALUATION OF CLINICAL AND RADIOLOGICAL PROGNOSTIC FACTORS
Abstract
Background
Traumatic brain injury (TBI) remains a signifcant health burden worldwide. The management, the demographic data and the outcomes vary center to center depending on the regions and pre-ıcu resources.
Objectives
Aim: To analyse the outcomes and the factors affecting the outcomes of children with severe traumatic brain injury admitted to our hospital in Turkey.
Methods
Medical records of children with severe traumatic brain injury admitted to our Pediatric Intensive Care Unit over a 7-year period were retrospectively reviewed. Patients were divided in to three categories according to Glasgow outcome scale performed at PICU discharge, GOS of 1: the children who died, GOS of 2-3: poor neurological outcome, GOS of 4-5: good neurological outcome and compared according to demographic, clinical and radiological data.
Results
A total of 62 patients were analyzed (median age:56 months; 35 boys). Most common mechanisms of injury was fall from a height (n=24, 38.7%). Twenty-four patients died (38.7%). Seven patients were discharged with poor neurological outcome,half of the patients (n=31) were discharged with good neurological outcome. Presence of CPR before admission, GCS of 3-5 at admission, hypotension at admission, metabolic acidosis during the first 24 hours, effacement of basal cisterns on first Cranial CT , PTS , ISS , blood sodium level of first day, INR level at admission was statistically significant between patients who died and patients with poor and good neurological outcome.
Conclusion
To evalute the factors affecting the outcomes of children with severe traumatic brain injury.may improve the outcomes in regions that have limited resources with poor pre-ıcu management.