title: Blood pressure and outcome after severe pediatric traumatic brain injury.
abstract: BACKGROUND
  The relationship between systolic blood pressure and outcome in children after severe traumatic brain injury (TBI) is unclear. We examined the relationship between age-appropriate systolic blood pressure (AASBP) percentile and outcome after severe pediatric TBI.
  
  
  METHODS
  We examined the association between AASBP percentiles and outcome in 172 children younger than 14 years of age with a Glasgow Coma Scale score < 9. Outcome was evaluated using discharge Glasgow Outcome Scale score. Poor outcome was defined as a Glasgow Outcome Scale score < 4.
  
  
  RESULTS
  Poor outcome was associated with AASBP < 75th percentile (odds ratio, 4.2; 95% confidence interval, 2.1-8.3). Patients with systolic blood pressure (SBP) > or = 90 mm Hg and AASBP < 75th percentile had a higher odds for poor outcome compared with patients with SBP > or = 90 mm Hg and AASBP > or = 75th percentile (odds ratio, 3.5; 95% confidence interval, 1.7-7.3). CONCLUSION AASBP < 75th percentile was associated with poor outcome after severe pediatric TBI, even when SBP was > or = 90 mm Hg.
authors.affiliation: Department of Anesthesiology, Harborview Medical Center, University of Washington, Seattle, USA. vavilala@u.washington.edu
authors.forename: Monica S
authors.initials: MS
authors.lastname: Vavilala
authors.forename: Anna
authors.initials: A
authors.lastname: Bowen
authors.forename: Arthur M
authors.initials: AM
authors.lastname: Lam
authors.forename: Joshua C
authors.initials: JC
authors.lastname: Uffman
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Powell
authors.forename: H Richard
authors.initials: HR
authors.lastname: Winn
authors.forename: Frederick P
authors.initials: FP
authors.lastname: Rivara
mesh_terms: D000046:Academic Medical Centers; D017677:Age Distribution; D000704:Analysis of Variance; D001794:Blood Pressure; D001930:Brain Injuries / Q000150:complications* / Q000209:etiology / Q000401:mortality* / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D015986:Confounding Factors, Epidemiologic; D016002:Discriminant Analysis; D005260:Female; D015600:Glasgow Coma Scale; D023261:Glasgow Outcome Scale; D006801:Humans; D007022:Hypotension / Q000175:diagnosis / Q000209:etiology*; D016015:Logistic Models; D008297:Male; D011237:Predictive Value of Tests; D012016:Reference Values; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D013599:Systole; D014193:Trauma Centers; D016896:Treatment Outcome; D014861:Washington / Q000453:epidemiology