TY  - JOUR
PY  - 2022//
TI  - Incidence of traumatic brain injuries in head-injured children with seizures
JO  - Emergency medicine Australasia
A1  - Borland, Meredith L.
A1  - Dalziel, Stuart R.
A1  - Phillips, Natalie
A1  - Dalton, Sarah
A1  - Lyttle, Mark D.
A1  - Bressan, Silvia
A1  - Oakley, Ed
A1  - Kochar, Amit
A1  - Furyk, Jeremy
A1  - Cheek, John A.
A1  - Neutze, Jocelyn
A1  - Eapen, Nitaa
A1  - Hearps, Stephen Jc
A1  - Rausa, Vanessa C.
A1  - Babl, Franz E.
SP  - ePub
EP  - ePub
VL  - ePub
IS  - ePub
N2  - OBJECTIVE: Incidence and short-term outcomes of clinically important traumatic brain injury (ciTBI) in head-injured children presenting to ED with post-traumatic seizure (PTS) is not described in current literature. <br><br>METHODS: Planned secondary analysis of a prospective observational study undertaken in 10 Australasian Paediatric Research in Emergency Department International Collaborative (PREDICT) network EDs between 2011 and 2014 of head-injured children <18 years with and without PTS. Clinical predictors and outcomes were analysed by attributable risk (AR), risk ratios (RR) and 95% confidence interval (CI), including the association with Glasgow Coma Scale (GCS) scores. <br><br>RESULTS: Of 20 137 head injuries, 336 (1.7%) had PTS with median age of 4.8 years. Initial GCS was 15 in 268/336 (79.8%, AR -16.1 [95% CI -20.4 to -11.8]), 14 in 24/336 (7.1%, AR 4.4 [95% CI 1.6-7.2]) and ≤13 in 44/336 (13.1%, AR 11.7 [95% CI 8.1-15.3]) in comparison with those without PTS, respectively. The ciTBI rate was 34 (10.1%) with PTS versus 219 (1.1%) without PTS (AR 9.0 [95% CI 5.8-12.2]) with 5/268 (1.9%), 6/24 (25.0%) and 23/44 (52.3%) with GCS 15, 14 and ≤13, respectively. In PTS, rates of admission ≥2 nights (34 [10.1%] AR 9.0 [95% CI 5.8-12.3]), intubation >24 h (9 [2.7%] AR 2.5 [95% CI 0.8-4.2]) and neurosurgery (8 [2.4%] AR 2.0 [95% CI 0.4-3.7]), were higher than those without PTS. Children with PTS and GCS 15 or 14 had no neurosurgery, intubations or death, with two deaths in children with PTS and GCS ≤13. <br><br>CONCLUSIONS: PTS was uncommon in head-injured children presenting to the ED but associated with an increased risk of ciTBI in those with reduced GCS on arrival.<p />  <p>Language: en</p>
LA  - en
SN  - 1742-6731
UR  - http://dx.doi.org/10.1111/1742-6723.14112
ID  - ref1
ER  -