| [Severe pediatric head injuries (II): factors associated to morbidity-mortality]. | |
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MedLine Citation:
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PMID: 21496960 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To describe the factors associated to morbidity-mortality in pediatric patients with severe head injury (SHI). MATERIAL AND METHOD: A review was made of the patients admitted to the Pediatric Intensive Care Unit (PICU) with SHI between July 1983 and December 2009. RESULTS: Of the 389 patients with head injuries, 174 (45%) presented SHI. The mean age of these subjects was 67 (9) months, with a Glasgow Coma Score (GCS) of 5.5 (1.8) and a PRISM score of 10.6 (6.7). Thirty-nine percent of the patients showed diffuse encephalic injury (DEI) in the computed tomography (CT) study. Seventy-nine percent of the patients subjected to intracranial pressure monitoring (ICP) presented intracranial hypertension. These patients had a greater incidence of serious sequelae (66.7 vs. 23.1%; p=0.01). Sequelae of clinical relevance were recorded in 59 patients (34%), and proved serious in 64% of the cases. The mortality rate among the patients with SHI was 24.7%, and mortality was significantly associated with a lower GCS score, hyperglycemia, intracranial hypertension and the presence of mydriasis or shock. The mortality rate associated to severe DEI was significantly higher than in the case of mild-moderate DEI (87.5 vs. 7.2%; p<0.001). The independent mortality risk factors in the pediatric patients with SHI were found to be the presence of mydriasis (OR: 31.27), intracranial hypertension (OR: 13.23) and hyperglycemia (OR: 3.10). CONCLUSIONS: a) SHI in pediatric patients was associated with high morbidity-mortality; b) intracranial hypertension was associated to the development of serious sequelae; c) independent mortality risk factors were the existence of mydriasis, intracranial hypertension and hyperglycemia. |
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Authors:
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J M López Álvarez; M E Valerón Lemaur; O Pérez Quevedo; J M Limiñana Cañal; A Jiménez Bravo de Laguna; E Consuegra Llapurt; A Morón Saén de Casas; R González Jorge |
Publication Detail:
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Type: English Abstract; Journal Article Date: 2011-04-14 |
Journal Detail:
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Title: Medicina intensiva / Sociedad Española de Medicina Intensiva y Unidades Coronarias Volume: 35 ISSN: 1578-6749 ISO Abbreviation: Med Intensiva Publication Date: 2011 Aug-Sep |
Date Detail:
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Created Date: 2011-07-15 Completed Date: 2011-12-19 Revised Date: 2012-01-18 |
Medline Journal Info:
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Nlm Unique ID: 9207689 Medline TA: Med Intensiva Country: Spain |
Other Details:
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Languages: spa Pagination: 337-43 Citation Subset: IM |
Copyright Information:
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Copyright © 2010 Elsevier España, S.L. y SEMICYUC. All rights reserved. |
Affiliation:
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Unidad de Medicina Intensiva Pediátrica, Complejo Hospitalario Universitario Insular Materno-Infantil de Canarias, Las Palmas de Gran Canaria, Las Palmas, España. jmloal@hotmail.com |
Vernacular Title:
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Traumatismo craneoencefálico pediátrico grave (II): factores relacionados con la morbilidad y mortalidad. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Child Child, Preschool Craniocerebral Trauma / complications*, mortality* Female Humans Injury Severity Score Male Retrospective Studies |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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