Prognostic factors in children with severe diffuse brain injuries

A study of 74 patients

Shibu Pillai, S. S. Praharaj, Aaron Mohanty, V. R Sastry Kolluri

Research output: Contribution to journalArticle

39 Citations (Scopus)

Abstract

Severe diffuse brain injury in children has a devastating influence on their physical and psychological development. This retrospective study was undertaken to analyse the factors that influence outcome in children with such injuries. The short-term outcomes (Glasgow outcome score) of 74 children (age ≤ 15 years) with severe diffuse brain injury and no focal operable mass lesions on CT scan, admitted between 1992 and 1998 at the National Institute of Mental Health and Neurosciences were analysed. The prognostic factors analysed were age, gender, time after injury to admission, nature of injury, highest post-resuscitation Glasgow coma score (GCS), pupillary reaction, horizontal oculocephalic reflex and CT scan findings. The following factors were found to be independent predictors of poor outcome: GCS 3-5 (p < 0.003), absent verbal response (p < 0.001), motor response score of 1-3 (p < 0.001), absent pupillary reaction (p < 0.001), absent oculocephalic reflex (p < 0.001) and presence of traumatic subarachnoid haemorrhage on CT scan (p < 0.002). These independent variables were then subjected to a stepwise logistic regression analysis, and the most important variables for predicting outcome were oculocephalic reflex and GCS, which together correctly predicted unfavourable outcome with a sensitivity of 79% and a specificity of 65%. An early CT scan or a single CT scan did not have any prognostic significance.

Original languageEnglish (US)
Pages (from-to)98-103
Number of pages6
JournalPediatric Neurosurgery
Volume34
Issue number2
DOIs
StatePublished - 2001
Externally publishedYes

Fingerprint

Coma
Reflex
Wounds and Injuries
Traumatic Subarachnoid Hemorrhage
National Institute of Mental Health (U.S.)
Abnormal Reflexes
Neurosciences
Resuscitation
Statistical Factor Analysis
Retrospective Studies
Logistic Models
Regression Analysis
Psychology
Diffuse Brain Injury

Keywords

  • Diffuse brain injury
  • Head trauma
  • Prognostic factors

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Clinical Neurology

Cite this

Prognostic factors in children with severe diffuse brain injuries : A study of 74 patients. / Pillai, Shibu; Praharaj, S. S.; Mohanty, Aaron; Kolluri, V. R Sastry.

In: Pediatric Neurosurgery, Vol. 34, No. 2, 2001, p. 98-103.

Research output: Contribution to journalArticle

Pillai, Shibu ; Praharaj, S. S. ; Mohanty, Aaron ; Kolluri, V. R Sastry. / Prognostic factors in children with severe diffuse brain injuries : A study of 74 patients. In: Pediatric Neurosurgery. 2001 ; Vol. 34, No. 2. pp. 98-103.
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