期刊
PEDIATRIC NEUROSURGERY
卷 34, 期 3, 页码 131-137出版社
KARGER
DOI: 10.1159/000056008
关键词
head injury; disseminated intravascular coagulation; Glasgow coma scale; Glasgow outcome score
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. Copyright (C) 2001 S. Karger AG, Basel.
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