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The influence of hemocoagulative disorders on the outcome of children with head injury.

AbstractBACKGROUND:
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.
AuthorsA Chiaretti, P Pezzotti, J Mestrovic, M Piastra, G Polidori, S Storti, F Velardi, C Di Rocco
JournalPediatric neurosurgery (Pediatr Neurosurg) Vol. 34 Issue 3 Pg. 131-7 (Mar 2001) ISSN: 1016-2291 [Print] Switzerland
PMID11359101 (Publication Type: Journal Article)
CopyrightCopyright 2001 S. Karger AG, Basel
Topics
  • Blood Coagulation Disorders (diagnosis, etiology)
  • Brain Injuries (blood, complications, diagnosis)
  • Child
  • Child, Preschool
  • Female
  • Glasgow Coma Scale
  • Humans
  • Male
  • Observation
  • Prospective Studies
  • Treatment Outcome

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