Document Detail

The influence of hemocoagulative disorders on the outcome of children with head injury.
MedLine Citation:
PMID:  11359101     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Although disseminated intravascular coagulation (DIC) and other hemocoagulative abnormalities are severe complications of head injury, their effect on clinical outcome remains unclear, particularly among children. OBJECTIVES: To evaluate the frequency of hemocoagulative abnormalities and their influence on outcome among children with head injury. STUDY DESIGN: We conducted a prospective observational study among 60 children with head injury, immediately evaluating severity of head injury (Glasgow Coma Scale, GCS); cerebral axial tomography; prothrombin time; activated partial thromboplastin time (aPTT); fibrinogen level; concentration of fibrin-fibrinogen degradation products (FDP), and platelet count. Two months after injury, we applied the Glasgow Outcome Score (GOS). Associations with GOS were evaluated using univariate and multivariate logistic models. RESULTS: Among children with severe head injury, 22.2% (6/27) developed DIC, all of whom died and had shown severe brain edema. Among those with severe head injury yet without DIC, the mortality was only 14.2%. A low GOS was significantly and independently associated with a low GCS, multiple trauma, delayed aPTT, low fibrinogen level, elevated FDP and low platelet count. Brain edema was also associated with a low GOS, though not significantly. CONCLUSIONS: In addition to GCS, type of trauma, type of brain lesion and certain coagulation abnormalities are predictors of GOS.
A Chiaretti; P Pezzotti; J Mestrovic; M Piastra; G Polidori; S Storti; F Velardi; C Di Rocco
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pediatric neurosurgery     Volume:  34     ISSN:  1016-2291     ISO Abbreviation:  Pediatr Neurosurg     Publication Date:  2001 Mar 
Date Detail:
Created Date:  2001-05-18     Completed Date:  2001-08-23     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9114967     Medline TA:  Pediatr Neurosurg     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  131-7     Citation Subset:  IM    
Copyright Information:
Copyright 2001 S. Karger AG, Basel
Pediatric Intensive Care Unit, Catholic University Medical School, I-00168 Rome, Italy.
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MeSH Terms
Blood Coagulation Disorders / diagnosis*,  etiology
Brain Injuries / blood*,  complications,  diagnosis
Child, Preschool
Glasgow Coma Scale
Prospective Studies
Treatment Outcome

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