Risk factors for mortality in children with abusive head trauma.

The Journal of Pediatrics
Steven L SheinRachel Pardes Berger

Abstract

We sought to identify risk factors for mortality in a large clinical cohort of children with abusive head trauma. Bivariate analysis and multivariable logistic regression models identified demographic, physical examination, and radiologic findings associated with in-hospital mortality of children with abusive head trauma at 4 pediatric centers. An initial Glasgow Coma Scale (GCS) ≤ 8 defined severe abusive head trauma. Data are shown as OR (95% CI). Analysis included 386 children with abusive head trauma. Multivariable analysis showed children with initial GCS either 3 or 4-5 had increased mortality vs children with GCS 12-15 (OR = 57.8; 95% CI, 12.1-277.6 and OR = 15.6; 95% CI, 2.6-95.1, respectively, P < .001). Additionally, retinal hemorrhage (RH), intraparenchymal hemorrhage, and cerebral edema were independently associated with mortality. In the subgroup with severe abusive head trauma and RH (n = 117), cerebral edema and initial GCS of 3 or 4-5 were independently associated with mortality. Chronic subdural hematoma was independently associated with survival. Low initial GCS score, RH, intraparenchymal hemorrhage, and cerebral edema are independently associated with mortality in abusive head trauma. Knowledge of these risk...Continue Reading

References

May 1, 1978·Journal of Neurosurgery·D A BruceL N Sutton
Dec 1, 1992·Archives of Disease in Childhood·A C Elias-JonesT Jaspan
Jan 1, 1988·Intensive Care Medicine·Z BarzilayH Boichis
Mar 1, 1987·Journal of Neurosurgery·A C DuhaimeR Wiser
Jan 1, 1985·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·J EsparzaE Lamas
Jul 13, 1974·Lancet·G Teasdale, B Jennett
Sep 1, 1993·Critical Care Medicine·B GoldsteinC Cox
Mar 1, 1993·Journal of Pediatric Surgery·F A PigulaD W Vane
Jun 1, 1996·Pediatric Neurosurgery·A C DuhaimeT Seidl
Mar 1, 1997·Pediatrics·K P HymelC Jenny
Feb 1, 1997·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·S H SongY Kim
Mar 13, 1998·Archives of Disease in Childhood·J Haviland, R I Russell
Sep 5, 1998·Anesthesia and Analgesia·G A OrliaguetP A Carli
Feb 24, 1999·JAMA : the Journal of the American Medical Association·C JennyT C Hay
Jul 27, 1999·The Journal of Trauma·H J FeickertR Heyer
Nov 5, 1999·Neuroreport·M A Pérez-PinzónW D Dietrich
May 19, 2001·Pediatric Neurosurgery·A ChiarettiC Di Rocco
May 25, 2001·Critical Care Medicine·J R WhiteD G Nichols
Apr 6, 2002·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Antonio ChiarettiConcezio Di Rocco
May 1, 2002·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Antonio ChiarettiConcezio Di Rocco
Nov 16, 2002·American Journal of Respiratory and Critical Care Medicine·R Scott WatsonDerek C Angus
May 27, 2003·Archives of Disease in Childhood·A M KempK W Kemp
Aug 7, 2003·JAMA : the Journal of the American Medical Association·Heather T KeenanSara H Sinal
Oct 3, 2003·Pediatrics·Christine BonnierGuillaume Sébire
Jun 17, 2004·The Canadian Journal of Neurological Sciences. Le Journal Canadien Des Sciences Neurologiques·Craig G N CampbellJames S Hutchison
Jul 15, 2004·Blood·Ching-Hon PuiUNKNOWN Total Therapy Study XIIIB at St Jude Children's Research Hospital
Apr 20, 2006·Journal of Neurosurgery·Patrick Graupman, Ken R Winston
May 2, 2006·Pediatric Neurology·Chia-Ying ChungAlice May-Kuen Wong
Aug 4, 2006·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Sarah C DucrocqPierre A Carli
Jun 15, 2007·Journal of Pediatric Surgery·Richard A FalconeVictor F Garcia
Jun 6, 2008·The New England Journal of Medicine·James S HutchisonUNKNOWN Hypothermia Pediatric Head Injury Trial Investigators and the Canadian Critical Care Trials Group
Sep 12, 2008·The New England Journal of Medicine·Kees H PoldermanDavid Menon

❮ Previous
Next ❯

Citations

Jun 6, 2013·Child Abuse & Neglect·Philip V ScribanoRachel P Berger
Apr 4, 2014·Journal of Neurotrauma·Kimberly A FosterElizabeth C Tyler-Kabara
May 20, 2015·Critical Care Nursing Clinics of North America·Donna L MoyerSamara A Champion
May 13, 2014·European Journal of Radiology·Tessa Sieswerda-HoogendoornRick R van Rijn
Dec 3, 2014·Journal of AAPOS : the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus·Susannah Q LongmuirMichael D Abramoff
Oct 8, 2013·Journal of Pediatric Surgery·Camille L StewartDenis D Bensard
Jan 15, 2013·The Journal of Pediatrics·Ann S Botash
Nov 15, 2015·Journal of Neurotrauma·Marion BailhacheLouis Rachid Salmi
Nov 2, 2016·Journal of Neurosurgery. Pediatrics·Scott BoopPaul Klimo
Oct 22, 2016·Child Abuse & Neglect·Megan M LetsonRachel P Berger
Apr 22, 2017·Critical Care Medicine·Nikki Miller FergusonUNKNOWN Investigators of the Approaches and Decisions in Acute Pediatric Traumatic Brain Injury (ADAPT) Trial
Dec 19, 2017·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Shunsuke AmagasaKosaku Kinoshita
Feb 21, 2018·Hispanic Health Care International : the Official Journal of the National Association of Hispanic Nurses·Sarah V DuzinskiKarla A Lawson
Jan 6, 2018·Graefe's Archive for Clinical and Experimental Ophthalmology = Albrecht Von Graefes Archiv Für Klinische Und Experimentelle Ophthalmologie·An-Lun WuWei-Chi Wu
Dec 6, 2018·Topics in Magnetic Resonance Imaging : TMRI·Sara Reis TeixeiraGiulio Zuccoli
Oct 26, 2018·European Journal of Pediatrics·Oliver BertholdJörg M Fegert
Jun 3, 2017·Journal of Neurosurgery. Pediatrics·Nickalus R KhanPaul Klimo
Jul 3, 2019·Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz·Oliver BertholdJörg M Fegert
Nov 8, 2013·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Baxter B AllenJeffrey P Greenfield
May 20, 2016·Anesthesia and Analgesia·Jennifer K LeeNina Deutsch
Mar 14, 2019·The Journal of Trauma and Acute Care Surgery·Miriam NuñoJulia N Magaña
Feb 28, 2020·Journal of Physical Activity & Health·Karen TongeAnthony D Okely
Feb 23, 2013·Current Opinion in Pediatrics·Genevieve PreerAlice W Newton
Mar 23, 2019·Journal of Clinical Medicine·Chih-Chi ChenUNKNOWN Prevention, Protection Against Child Abuse, Neglect (PCHAN) Study Group
Apr 23, 2016·The Journal of Trauma and Acute Care Surgery·Christine M LeeperBarbara A Gaines
Sep 29, 2017·British Journal of Nursing : BJN·Francesca Louise PayneSiba Prosad Paul
Oct 31, 2020·Archives of Disease in Childhood·Kathryn GlennAlison Mary Kemp
Nov 10, 2020·Korean Journal of Neurotrauma·Won Jae LeeSoo Han Yoon
Mar 15, 2021·Journal of Pediatric Surgery·Jordan E JacksonMiriam Nuño

❮ Previous
Next ❯

Related Concepts

Related Feeds

Brain Injury & Trauma

brain injury after impact to the head is due to both immediate mechanical effects and delayed responses of neural tissues.