Evaluation of Common Experience of Neurosurgery and Pediatric Intensive Care Unit on Pediatric Head Trauma under the Light of Current Literature: Analysis of 96 Cases


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Gürbüz M. S. , Duyu M.

Haydarpaşa Numune Medical Journal, cilt.59, ss.272-282, 2019 (Hakemli Üniversite Dergisi)

  • Cilt numarası: 59 Konu: 3
  • Basım Tarihi: 2019
  • Doi Numarası: 10.14744/hnhj.2019.38980
  • Dergi Adı: Haydarpaşa Numune Medical Journal
  • Sayfa Sayıları: ss.272-282

Özet

Introduction: This study aimed to evaluate the features and injury mechanisms of pediatric head trauma, demographics

of the patients and factors affecting the outcome and to present the common experience of neurosurgery and pediatric

intensive care unit (PICU) in light of the current literature.

Methods: Ninety-six of 110 children under the age of 18 who had sufficient data and were treated in PICU for head trauma

between 2014 and 2018 were evaluated retrospectively. The association between age, sex, mechanism of injury, neurological

examination at presentation, Glasgow coma scale (GCS) score, history of cardiopulmonary resuscitation, shock, blood

glucose level, hypoxia, convulsion, mean arterial pressure, heart rate per minute, body temperature, intracranial pressure

(ICP) values, surgical interventions and Glasgow outcome scale (GOS) scores was investigated.

Results: There were 32 patients (33.3%) in mild head trauma group, 28 patients (29.1%) in moderate head trauma group and

36 patients (37.5%) in severe head trauma group. Isolated head trauma was present in 49 patients, and multitrauma was

observed in the remaining. The rate of favourable outcome was 72.9% (70 patients), and that of unfavourable outcome was

27.1% (26 patients) with the mortality rate of 15.6%. A moderate and negative correlation between presenting GCS scores

and presenting blood glucose levels (rho: -0.422 p<0.001), and a moderate and positive correlation between presenting GCS

scores and presenting body temperature were observed (rho: 0.422 p<0.001). A highly significant positive correlation was

observed between GCS and 1-year GOS scores (rho: 0.762 p<0.001).

Discussion and Conclusion: Analyzing the characteristics of pediatric head trauma, knowing the prognostic factors, developing

a common algorithm and standardizing the management parallel to current literature will contribute to a favourable

prognosis.