J Korean Neurosurg Soc.  2023 Sep;66(5):582-590. 10.3340/jkns.2022.0024.

Predictors of Outcome in Management of Paediatric Head Trauma in a Tertiary Healthcare Institution in North-Central Nigeria

• Bot GM
• Shilong DJ
• Philip JA
• Dung ED
• Shitta AH
• Kyesmen NI
• Alfin JD
• Houlihan LM
• Preul MC
• Ozoilo KN
• Binitie PO

• KMID: 2545349
• DOI: http://doi.org/10.3340/jkns.2022.0024

Abstract

Objective
: Trauma is a leading causes of death and disability in all ages. The aim of this study was to describe the demography and characteristics of paediatric head trauma in our institution and examine the predictors of outcome and incidence of injury related mortality.
Methods
: We examined our institutional Trauma Registry over a 2 year period.
Results
: A total of 1100 trauma patients were seen over the study period. Of the 579 patients who had head injury 99 were in the paediatric age group. Of the paediatric head trauma patients 79 had documented Glasgow coma score (GCS), 38 (48.1%), 17 (21.5%) and 24 (30.4%) had mild, moderate and severe head injury respectively. The percentage mortality of head injury in the paediatric age group was 6.06% (6/99). There is an association between mortality and GCS (p=0.008), necessity for intensive care unit (ICU) admission (p=0.0001), associated burns (p=0.0001) and complications such as aspiration pneumonia (p=0.0001). The significant predictors of outcome are aspiration (p=0.004), the need for ICU admission (p=0.0001) and associated burns (p=0.005) using logistic binary regression. During the study period 46 children underwent surgical intervention with extradural haematoma 16 (34.8%), depressed skull fracture 14 (30.4%) and chronic subdural haematoma five (10.9%) being the commonest indication for surgeries.
Conclusion
: Paediatric head injury accounted for 9.0% (99/1100) of all trauma admissions. Majority of patients had mild or moderate injuries. Burns, aspiration pneumonitis and the need for ICU admission were important predictors of outcome in children with traumatic brain injury.

Keyword

Head injury; Traumatic brain injury; Outcome; Paediatric; Predictors; Nigeria

Figure

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  Fig. 1. Endotrachael intubation with oxygenation, without being connected to a mechanical ventilator. Used with permission from Barrow Neurological Institute, Phoenix, Arizona.

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  Fig. 2. Algorithm for the management of paediatric head injury. GCS : Glasgow coma score, HDU : high dependency unit, ICU : intensive care unit, ETT : endotracheal tube.

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