In:
Pediatric Neurosurgery, S. Karger AG, Vol. 34, No. 3 ( 2001), p. 131-137
Abstract:
〈 i 〉 Background: 〈 /i 〉 Although disseminated intravascular coagulation (DIC) and other hemocoagulative abnormalities are severe complications of head injury, their effect on clinical outcome remains unclear, particularly among children. 〈 i 〉 Objectives: 〈 /i 〉 To evaluate the frequency of hemocoagulative abnormalities and their influence on outcome among children with head injury. 〈 i 〉 Study Design: 〈 /i 〉 We conducted a prospective observational study among 60 children with head injury, immediately evaluating severity of head injury (Glasgow Coma Scale, GCS); cerebral axial tomography; prothrombin time; activated partial thromboplastin time (aPTT); fibrinogen level; concentration of fibrin-fibrinogen degradation products (FDP), and platelet count. Two months after injury, we applied the Glasgow Outcome Score (GOS). Associations with GOS were evaluated using univariate and multivariate logistic models. 〈 i 〉 Results: 〈 /i 〉 Among children with severe head injury, 22.2% (6/27) developed DIC, all of whom died and had shown severe brain edema. Among those with severe head injury yet without DIC, the mortality was only 14.2%. A low GOS was significantly and independently associated with a low GCS, multiple trauma, delayed aPTT, low fibrinogen level, elevated FDP and low platelet count. Brain edema was also associated with a low GOS, though not significantly. 〈 i 〉 Conclusions: 〈 /i 〉 In addition to GCS, type of trauma, type of brain lesion and certain coagulation abnormalities are predictors of GOS.
Type of Medium:
Online Resource
ISSN:
1016-2291
,
1423-0305
Language:
English
Publisher:
S. Karger AG
Publication Date:
2001
detail.hit.zdb_id:
1483546-0
