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

Autori
Chiaretti, A. ; Pezzotti, P. ; Meštrović, Julije ; Piastra, M. ; Polidori, G. ; Storti, S. ; Velardi, F. ; DiRocco, C.

Izvornik
Pediatric neurosurgery (1016-2291) 34 (2001); 131-137

Vrsta, podvrsta i kategorija rada
Radovi u časopisima, članak, znanstveni

Ključne riječi
head injury; disseminated intravascular coagulation; Glasgow coma scale; Glasgow outcome score

Sažetak
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.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

POVEZANOST RADA