title: Prognostic factors of severe traumatic brain injury outcome in children aged 2-16 years at a major neurosurgical referral centre.
abstract: BACKGROUND
  Traumatic Brain Injury (TBI) in children has been poorly studied, and the literature is limited. We evaluated 146 children with severe TBI (coma score less than 8) in an attempt to establish the prognostic factors of severe TBI in children.
  
  
  METHODS
  The severity of TBI was assessed via modified Glasgow Coma Score for those more than 3 years old and via Children Coma Score for those under 3 years old. Clinical presentations, laboratory parameters and features of Computerised Tomography brain scans were analyzed. Outcomes were assessed at 6 months with the Pediatric Cerebral Performance Categories Scale; the outcomes were categorised as good or poor outcomes. Correlations with outcome were evaluated using univariate and multivariate logistic models.
  
  
  RESULTS
  A low coma score upon admission was independently associated with poor outcome. The presence of diabetes insipidus within 3 days post-TBI (OR: 1.9), hyperglycaemia (OR: 1.2), prolonged PT ratio (OR: 2.3) and leukocytosis (OR: 1.1) were associated with poorer outcome.
  
  
  CONCLUSIONS
  Knowledge of these prognostic factors helps neurosurgeons and neurocritical care specialists to manage and improve outcome in severe TBI in children.
authors.affiliation: Department of Neurosurgery, Hospital Kuala Lumpur, Jalan Pahang, 50586 Kuala Lumpur, Malaysia.
authors.forename: Choon Hong
authors.initials: CH
authors.lastname: Kan
authors.forename: Mohd
authors.initials: M
authors.lastname: Saffari
authors.forename: Teik Hooi
authors.initials: TH
authors.lastname: Khoo