| The influence of hemocoagulative disorders on the outcome of children with head injury. | |
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MedLine Citation:
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PMID: 11359101 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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A Chiaretti; P Pezzotti; J Mestrovic; M Piastra; G Polidori; S Storti; F Velardi; C Di Rocco |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Pediatric neurosurgery Volume: 34 ISSN: 1016-2291 ISO Abbreviation: Pediatr Neurosurg Publication Date: 2001 Mar |
Date Detail:
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Created Date: 2001-05-18 Completed Date: 2001-08-23 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 9114967 Medline TA: Pediatr Neurosurg Country: Switzerland |
Other Details:
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Languages: eng Pagination: 131-7 Citation Subset: IM |
Copyright Information:
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Copyright 2001 S. Karger AG, Basel |
Affiliation:
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Pediatric Intensive Care Unit, Catholic University Medical School, I-00168 Rome, Italy. chiarant@katamail.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Blood Coagulation Disorders
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diagnosis*,
etiology Brain Injuries / blood*, complications, diagnosis Child Child, Preschool Female Glasgow Coma Scale Humans Male Observation Prospective Studies Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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