Abstract
Objectives: We aimed to determine prognostic factors that can influence the outcome of severe traumatic brain injury (TBI) in children.
Materials and methods: One hundred and sixty-nine patients with severe TBI were included. Consciousness was evaluated using the Glasgow Coma Scale (GCS). Severity of concomitant injuries was evaluated using the Injury Severity Score (ISS). Computer tomography (CT) scanning was used on admission and later. Intracranial injuries were classified using the Marshall CT scale. Intracranial pressure (ICP) monitoring took place in 80 cases. Serum samples of 65 patients were tested for S-100β protein and of 43 patients for neuron specific enolase (NSE). Outcomes were evaluated 6 months after trauma using the Glasgow Outcome Scale (GOS). Statistical and mathematical analysis was conducted. The accuracy of our prognostic model was defined in another group of patients (n = 118).
Results: GCS, pupil size and photoreaction, ISS, hypotension and hypoxia are significant predictors of outcome of severe TBI in children. CT results complement the forecast significantly. The accuracy of surviving prognosis came to 76% (0.76) in case of S-100β protein level ≤ 0.25 μg/l and NSE level < 19 μg/l. A mathematical model of outcome prognosis was based on discriminant function analysis. The model of prognosis was tested on the control group. The accuracy of prognosis was 86%.
Conclusions: A personalised prognostic model makes it possible to predict the outcome of severe TBI in children on the first day after trauma.
References
Potapov АА, Lihterman LB, Kravchuk AD, et al. Modern approaches to the study and treatment of traumatic brain injury. Ann Clin Exp Neurol. 2010;4(1):4–12.
Puras YuV, Talipov AE, Krilov VV, et al. Risk factors for poor outcome in the surgical treatment of severe traumatic brain injury. Russian J Neurosurg. 2013;(2):С.8–16.
Andriessen TM, Horn J, Franschman G, et al. Epidemiology, severity classification, and outcome of moderate and severe traumatic brain injury: a prospective multicenter study. J Neurotrauma. 2011;28(10):2019–31.
Brain Trauma Foundation, American Association of Neurological Surgeons, Congress of Neurological Surgeons. BTF guidelines for the management of severe traumatic brain injury (3rd edition). J Neurotrauma. 2007;24(Suppl):1–106.
Kan CH, Saffari M, Khoo TH. Prognostic factors of severe traumatic brain injury outcome in children aged 2–16 years at a major neurosurgical referral centre. Malays J Med Sci. 2009;16(4):25–33.
Perel P, Edwards P, Wentz R, et al. Systematic review of prognostic models in traumatic brain injury. BMC Med Inform Decis Mak. 2006;6:38.
Berger RP. The use of serum biomarkers to predict outcome after traumatic brain injury in adults and children. J Head Trauma Rehabil. 2006;21(4):315–33.
Bettermann K, Slocomb JE. Clinical relevance of biomarkers for traumatic brain injury. In: Dambinova S, Hayes RL, Wang KKW, editors. Biomarkers for traumatic brain injury. Cambridge: Royal Society of Chemistry; 2012. p. 1–18.
Pinelis VG, Sorokina EG, ZhB S, Reutov VP, Meshcheryakov SV, et al. Biomarkers of brain damage due to traumatic brain injury in children. Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova. 2015;115(8):66–72.
Sorokina EG, Semenova ZB, Reutov VP, Meshcheryakov SV. Autoantibodies to glutamate receptors and products of nitric oxide metabolism in serum in children in the acute phase of craniocerebral trauma. Neurosci Behav Physiol. 2009;39(4):329–34.
Kochanek PM, Carney N, David AP, et al. Guidelines for the acute medical management of severe traumatic brain injury in infants, children and adolescents, second edition. Pediatr Crit Care Med. 2012, 131;(Suppl):S1–82.
Marshall L, Gautille T, Klauber M, Eisenberg H, Jane J, Luerssen T, et al. The outcome of severe closed head injury. Special Supplements. 1991;75(1S):S28–36.
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Meshcheryakov, S.V., Semenova, Z.B., Lukianov, V.I., Sorokina, E.G., Karaseva, O.V. (2018). Prognosis of Severe Traumatic Brain Injury Outcomes in Children. In: Heldt, T. (eds) Intracranial Pressure & Neuromonitoring XVI. Acta Neurochirurgica Supplement, vol 126. Springer, Cham. https://doi.org/10.1007/978-3-319-65798-1_3
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