Factors affecting mortality in Pediatric Severe Head Injury

Abstract

Aim: It is aimed to determine the factors affecting mortality in pediatric patients followed up with severe traumatic brain injury in the pediatric intensive care unit. Material and method: All patients followed up in the Pediatric Intensive Care Unit between April 2019 and April 2021 due to severe traumatic brain injury were included. Demographic characteristics, pre-intensive care interventions and imaging findings, treatments applied in intensive care and intervention information of all patients were collected. Results were evaluated as survival rate, presence of tracheostomy requirement, brain death, and Pediatric Cerebral Performance Scale at discharge. The patients divided into two groups as survivors and non-survivors. All obtained data were compared between the two groups. Results: During the study period, 47 patients with a diagnosis of severe traumatic brain injury were followed up. It was observed that the requirement of cardiopulmonary resuscitation, the need for inotrope-vasopressor and the need for erythrocyte transfusion were statistically significantly higher in the non-survivor group. (p value, respectively: 0.001, 0.001, 0.001) The survival rate in all patients in the study group was 70.2%. In non-survivor group most common pupil response at admission was fixed-dilated (71.4%). In non-survivor group 60% of the patients were lost in the first 24 hours of intensive care. Conclusion: Mortality increases in patients who need resuscitation, erythrocyte transfusion and inotrope before intensive care. Patients who died showed pathologic pupillary response and low GCS. Severe TBH patients died mostly in first 24 hours of admission.

Keywords

• children
• intensive care
• severe head trauma
• ağır kafa travması
• çocuk
• yoğun bakım