Incidence of traumatic brain injuries in head-injured children with seizures.

Autor: Borland ML; Emergency Department, Perth Children's Hospital, Perth, Western Australia, Australia.; Divisions of Paediatrics and Emergency Medicine, School of Medicine, The University of Western Australia, Perth, Western Australia, Australia., Dalziel SR; Children's Emergency Department, Starship Children's Hospital, Auckland, New Zealand.; Departments of Surgery and Paediatrics: Child and Youth Health, The University of Auckland, Auckland, New Zealand., Phillips N; Emergency Department, Queensland Children's Hospital, Brisbane, Queensland, Australia.; Child Health Research Centre, School of Medicine, The University of Queensland, Brisbane, Queensland, Australia., Dalton S; Emergency Department, The Children's Hospital at Westmead, Sydney, New South Wales, Australia., Lyttle MD; Emergency Department, Bristol Royal Hospital for Children, Bristol, UK.; Academic Department of Emergency Care, University of the West of England, Bristol, UK., Bressan S; Department of Women's and Children's Health, University of Padova, Padova, Italy., Oakley E; Emergency Department, The Royal Children's Hospital, Melbourne, Victoria, Australia.; Department of Paediatrics and Centre for Integrated Critical Care, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia., Kochar A; Emergency Department, Women's and Children's Hospital, Adelaide, South Australia, Australia., Furyk J; Emergency Department, The Townsville Hospital, Townsville, Queensland, Australia.; School of Medicine, Deakin University, Melbourne, Victoria, Australia.; University Hospital Geelong, Geelong, Victoria, Australia., Cheek JA; Emergency Department, The Royal Children's Hospital, Melbourne, Victoria, Australia.; Department of Paediatrics and Centre for Integrated Critical Care, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia., Neutze J; Emergency Department, Kidz First Children's Hospital, Auckland, New Zealand., Eapen N; Murdoch Children's Research Institute, Melbourne, Victoria, Australia., Hearps SJ; Murdoch Children's Research Institute, Melbourne, Victoria, Australia., Rausa VC; Murdoch Children's Research Institute, Melbourne, Victoria, Australia., Babl FE; Emergency Department, The Royal Children's Hospital, Melbourne, Victoria, Australia.; Department of Paediatrics and Centre for Integrated Critical Care, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia.
Jazyk: angličtina
Zdroj: Emergency medicine Australasia : EMA [Emerg Med Australas] 2023 Apr; Vol. 35 (2), pp. 289-296. Date of Electronic Publication: 2022 Nov 02.
DOI: 10.1111/1742-6723.14112
Abstrakt: 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.
Methods: Planned secondary analysis of a prospective observational study undertaken in 10 Australasian Paediatric Research in Emergency Departments 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.
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.
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.
(© 2022 The Authors. Emergency Medicine Australasia published by John Wiley & Sons Australia, Ltd on behalf of Australasian College for Emergency Medicine.)
Databáze: MEDLINE
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