[Prognosis in pediatric traumatic brain injury. A dynamic cohort study].

Rev Med Inst Mex Seguro Soc

Servicio de Pediatría, Hospital General Regional 110, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco, Mexico.

Published: November 2013

Background: traumatic brain injury is a main cause of hospital admission and death in children. Our objective was to identify prognostic factors of pediatric traumatic brain injury.

Methods: this was a dynamic cohort study of traumatic brain injury with 6 months follow-up. The exposition was: mild or moderate/severe traumatic brain injury, searching for prognosis (morbidity-mortality and decreased Glasgow scale). Relative risk and logistic regression was estimated for prognostic factors.

Results: we evaluated 440 patients with mild traumatic brain injury and 98 with moderate/severe traumatic brain injury. Morbidity for mild traumatic brain injury was 1 %; for moderate/severe traumatic brain injury, 5 %. There were no deaths. Prognostic factors for moderate/severe traumatic brain injury were associated injuries (RR = 133), fractures (RR = 60), street accidents (RR = 17), night time accidents (RR = 2.3) and weekend accidents (RR = 2). Decreased Glasgow scale was found in 9 %, having as prognostic factors: visible injuries (RR = 3), grown-up supervision (RR = 2.5) and time of progress (RR = 1.6).

Conclusions: there should be a prognosis established based on kinetic energy of the injury and not only with Glasgow Scale.

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