Background Prediction of outcome based on certain prognostic factors is still challenging in paediatric traumatic brain injuries (TBI). Purpose of our study is to evaluate prognostic factors and outcome in children with TBI admitted in PICU.
Methods The sample was 252 children with TBI who were admitted to PICU of Hippokratio General Hospital of Thessaloniki from 1999 to 2012. The statistical analysis was performed with the statistical package SPSS 17 and the application of statistical tests x2-test, anova, Mann Whitney test, t-test and Pearson Correlation. Age, sex, Glasgow Coma Scale (GCS), Paediatric Risk Index of Mortality (PRISM score), days of mechanical ventilation, hypotension and need of inotropic support as well as late hyperglycemia were correlated to outcome.
Results Age groups, sex and mechanism of injury showed no correlation to outcome. Patients who died had statistically significant higher mean PRISM score (25,7 ± 8,4),compared with patients with good outcome (7,5 ± 4,7). The application of Pearson Correlation showed that the increased rating of PRISM score, as well as the low grading GCS were positively correlated to death, late hyperglycemia, haemodynamic instability, use of inotrops, poor outcome and disabilities (p < 0,001).
Conclusion A high PRISM score, a low GCS, hypotension and hyperglycemia after the first 48 h, are directly associated with poor outcome and death. Knowledge of these prognostic factors may help neurocritical care specialists to improve outcome in paediatric TBI.