Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Pediatrics

Background: Head injury is a leading cause of morbidity and mortality among children. Understanding the prognostic factors will help to reduce their possible negative impact, together with the use of specific guidelines for treatment; can make a significant contribution to improve the prognosis of these patients. Aim: The aim of this study was to establish the prognostic factors of traumatic brain injury (TBI) in children and their relation to the outcome to decrease the rate of mortality & morbidity Methodology: This cohort study included 100 children with TBI at El Shiekh Zayed Specialized Hospital and Al Kasr Al Aini Emergency Hospital (7th floor). All patients were subjected to demographic classification, clinical assessment of vital signs, glascow coma score (GCS), pediatric trauma score (PTS), laboratory investigations and radiological investigations (CT scan).Results: We included a total of 100 children with a mean age of 6 y (±3.55), 57% were males and 43% were females. We conducted a regression analysis to identify risk factors that associated with bad outcome (death).The following factors were predictors for mortality; Presence of associated injuries (OR=1.12, P value= 0.01), cases presented with disturbed conscious level (OR= 2.14, P value<0.001) or vomiting (OR=1.23, P value<0.001), cases with hypotension (OR=7.96, P value= 0.01), cases with low GCS (OR=0.34, P value<0.001) or low Pediatric trauma score (OR=0.4, P value<0.001), cases with diabetes insipidus (OR=11.00, P value<0.001), anemia (OR=0.45, P value<0.001), thrombocytopenia (OR= 0.98, P value<0.001), or coagulopathy in the form of elevated INR (OR=12.55, P value<0.001) or decreased PC (OR=0.89, P value<0.001), hyperglycemia (OR=1.02, P value<0.001), Presence of hemorrhage in CT (OR=14.33, P value= 0.01)

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