@article{ref1,
title="Mortality in Children With Severe Head Trauma: Predictive Factors and Proposal for a New Predictive Scale",
journal="Neurosurgery",
year="2010",
author="Tude Melo, José Roberto and Rocco, Federico Di and Blanot, Stephane and Oliveira-Filho, Jamary and Roujeau, Thomas and Sainte-Rose, Christian and Duracher, Caroline and Vecchione, Antonio and Meyer, Philippe and Zerah, Michel",
volume="67",
number="6",
pages="1542-1547",
abstract="BACKGROUND:: Traumatic brain injury is a public health problem around the world, and recognition of systemic sources of secondary brain lesions is crucial to improve outcome. OBJECTIVE:: To identify the main predictors of mortality and to propose a grading scale to measure the risk of death. METHODS:: This retrospective study was based on medical records of children with severe traumatic brain injury who were hospitalized at a level I pediatric trauma center between January 2000 and December 2005. Multiple logistic regression analysis was done to identify independent factors related to mortality. A receiver-operating characteristics curve was performed to verify the accuracy of the multiple logistic regression, and associations that increased mortality were verified. RESULTS:: We identified 315 children with severe head injury. Median Glasgow Coma Scale score was 6, and median Pediatric Trauma Score was 4. Global mortality rate was 30%, and deaths occurred despite adequate medical management within the first 48 hours in 79% of the patients. Age < 2 years (P = .02), Glasgow Coma Scale ≤ 5 (P < 10), accidental hypothermia (P = .0002), hyperglycemia (P = .0003), and coagulation disorders (P = .02) were all independent factors predicting mortality. A prognostic scale ranging from 0 to 6 that included these independent factors was then calculated for each patient and resulted in mortality rates ranging from 1% with a score of 6 to 100% with a score of 0. CONCLUSION:: Independent and modifiable mortality predictors could be identified and used for a new grading scale correlated with the risk of mortality in pediatric traumatic brain injury.<p /> <p>Language: en</p>",
language="en",
issn="0148-396X",
doi="10.1227/NEU.0b013e3181fa7049",
url="http://dx.doi.org/10.1227/NEU.0b013e3181fa7049"
}