title: Increased risk of death associated with hypotension is not altered by the presence of brain injury in pediatric trauma patients.
abstract: BACKGROUND
  Hypotension is a well-known predictor of mortality in pediatric trauma patients. However, it is unknown whether the mortality rate is higher in patients with traumatic brain injury (TBI) than in those without TBI. We hypothesized that systemic hypotension increases mortality in pediatric patients with TBI more than it does in pediatric patients with extracranial injuries only.
  
  
  METHODS
  Multivariate logistic regression was used to determine the relationship between hypotension and the risk of death. Patients were then divided into 2 groups: TBI and No-TBI and the model was applied separately to each group.
  
  
  RESULTS
  Overall mortality was 2%. After adjusting for confounding variables, hypotension remained a strong independent predictor of mortality. However, the increased risk of death was similar in patients with and without TBI.
  
  
  CONCLUSIONS
  Hypotension is an important predictor of death in pediatric trauma patients. The increased risk of death associated with hypotension is similar with or without traumatic brain injury.
authors.affiliation: Division of Burns, Trauma and Surgical Critical Care, Department of Surgery, University of Texas Southwestern Medical School, 5323 Harry Hines Blvd, Dallas, TX 75390-9158, USA.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Gunst
authors.forename: Jason L
authors.initials: JL
authors.lastname: Sperry
authors.forename: Vafa
authors.initials: V
authors.lastname: Ghaemmaghami
authors.forename: Richard F
authors.initials: RF
authors.lastname: Gunst
authors.forename: Randall S
authors.initials: RS
authors.lastname: Friese
authors.forename: Heidi L
authors.initials: HL
authors.lastname: Frankel
authors.forename: Larry M
authors.initials: LM
authors.lastname: Gentilello
authors.forename: Shahid
authors.initials: S
authors.lastname: Shafi
mesh_terms: D000293:Adolescent; D019540:Area Under Curve; D001930:Brain Injuries / Q000453:epidemiology* / Q000401:mortality; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007022:Hypotension / Q000453:epidemiology* / Q000401:mortality; D007223:Infant; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D018570:Risk Assessment