[Early predictors of outcome in children with head injuries].
In an attempt to determine whether the clinical data obtained by primary survey may be used as early outcome predictors in children who had sustained head trauma, children aged 0-14 with clinical diagnoses of coma, contusion, comotio, skull fracture or a combination of these diagnoses or who had been hospitalized for at least 3 days, between 1987 and 1990, were reviewed retrospectively. The outcome was defined by the clinical condition of children 6 months following head trauma using a Glasgow outcome scale (GOS), and was classified: good (good recovery and moderate disability) and poor (severe disability, persistent vegetative state, death). Of 70 children with trauma, 43 patients (61.4%) were separated by this method. The pupillary appearance and reactivity, Glasgow coma scale (GCS) and motor response graded by GCS were compared with the outcome. The analysis demonstrated that the early significant predictors of outcome of head trauma are the pupillary appearance and reactivity as well as Glasgow coma scale. Motor response graded by GCS did not achieve statistical significance (z = 1.5, P > 0.05) as a predictor of outcome. In this analysis, we have graded motor response according to the GCS criteria, thus it is not excluded that the use of different criteria could demonstrate the importance of motor response as an outcome predictor. In order to ascertain the significance of predictors in early outcome prognosis of head trauma, a relative risk for poor outcome was calculated. Our results showed that the significant predictors in descending order of preference are: pupillary reactivity, pupillary appearance and GCS.(ABSTRACT TRUNCATED AT 250 WORDS)
Prpić
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I
Klinicki bolnicki centar Rijeka, Klinika za djecje bolesti, Kantrida.
Gazdik
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M
Zeidler
F
F
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D006259:Craniocerebral Trauma / Q000175:diagnosis*; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D007223:Infant; D008297:Male; D011379:Prognosis
Rani prediktori ishoda trauma glave u djece.