Head trauma in children, part 1: admission, diagnostics, and findings.
The objective of this study is to describe and to determine the preclinical situation and early in-clinical situation, diagnostic findings, and factors influencing the outcome of severe head trauma in children. Records of 48 children (0-16 years) were analyzed during a 3-year interval. Correlations with the outcome (Glasgow Outcome Scale) were determined by focusing on different scales, clinical findings, biochemistry, and clinical course features. The initial shock index had a major relevance (P = .0089). Systolic blood pressure (P = .0002) and bradycardia (P = .035) were important factors. Assessing the severity of trauma according to the Glasgow Coma Score, the most accurate parameter for outcome is based on the detailed quality of ''eye opening'' (P = .0155). Pupillary motoricity at the accident site (P = .002) and emergency room (P = .0004) are strong predictors. Preclinical measurements of stabilization and oxygenation have the same impact as the in-clinical management.
Kapapa
Thomas
T
Department of Neurosurgery, University of Ulm, 89075 Ulm, Germany. Thomas.Kapapa@uniklinik-ulm.de
König
Kathrin
K
Pfister
Ulrike
U
Sasse
Michael
M
Woischneck
Dieter
D
Heissler
Hans
H
Rickels
Eckhard
E
D000293:Adolescent; D001794:Blood Pressure; D002648:Child; D002675:Child, Preschool; D006259:Craniocerebral Trauma / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011379:Prognosis; D012025:Reflex, Pupillary; D012720:Severity of Illness Index; D012769:Shock / Q000175:diagnosis / Q000628:therapy; D016896:Treatment Outcome