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A Study to Predict Outcome and Analysis of Factors Affecting Outcome in Pediatric Population with Severe Head Injury

Jyothi S.M., Associate Professor, Department of Radio Diagnosis, Malla Reddy Institute of Medical Sciences, Suraram, Hyderabad, Telangana 500055, India. , Venugopal Gudla* , Jyothi S.M.**

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International Journal of Neurology and Neurosurgery 9(2):p 143-148, Jul-Dec 2017. | DOI: http://dx.doi.org/10.21088/ijnns.0975.0223.9217.11

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Context: Study of outcome and analyzing various factors is important in various settings to identify factors that can lead to serious sequel but at the same time if identified early, are preventable, thereby leading to better management and good outcome in children. Aims: To study the outcome and analyze factors that affect outcome in children with severe head injury. Settings and Design: A hospital based prospective study was carried out at Osmania Medical College and General Hospital, Hyderabad. Methods and Material: A hospital based prospective study was carried out among 764 eligible children less than 14 years of age with head injury. Statistical Analysis: The data was entered in Microsoft Excel Worksheet and analyzed using proportions. Appropriate statistical test was applied wherever necessary. Results: Maximum cases were seen in children less than three years of age. But the proportion of severe head injuries was more among older children of 914 years. Most common mode of head injury was fall from height. Mild head injury was most common. Linear type of skull fracture was most common finding. Extradural hematoma was the most common intracranial hematoma. Vomiting was the most common presentation. Conservative management was carried out in maximum number of cases. Poor GCS score of 35, presence of pupillary abnormality, and presence of diffuse cerebral edema were found to be significant predictors of poor outcome among children (p < 0.05). Conclusion: Endotracheal intubation, elective ventilation for patient with poor GCS and early tracheostomy when necessary have shown good outcome in children with diffuse brain injury. Poor GCS at presentation, presence of shock, presence of diffuse cerebral edema on CT scan were the factors associated with poor prognosis.

Keywords: Outcome; Factors; Head Injury; Children; Prognosis. 

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DOI: http://dx.doi.org/10.21088/ijnns.0975.0223.9217.11

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