PW 2741 Identification of hospital based factors associated with 30-days clinical outcomes in pediatric patients with head injury. (November 2018)

• Record Type: Journal Article
• Authors: Mian, Asad; Ahmed, Fareed; Khan, Uzma R; Razzak, Junaid A
• Is Part Of: Injury prevention. Volume 24(2018)Supplement 2
• Page Start: A144
• Page End: A145
• Publication Date: 2018-11
• Subjects: Children's accidents -- Prevention -- Periodicals; Accidents -- Prevention -- Periodicals; 617.1
• DOI: 10.1136/injuryprevention-2018-safety.400
• Languages: English
• ISSNs: 1353-8047

Abstract

Abstract : Pediatric patients with head injury present in a diverse way and it is critical to assess them and start proper management. One of the factors is delay in brain imaging (C.T scan) when patient present in grey area where GCS falls between mild to moderate head injury, which leads to subsequent delay in management and ultimately result in mortality and morbidity.There is lack of evidence till date on Hospital based factors associated with 30 day mortality in pediatric patient after head injury. To compare 30 day clinical outcome in pediatric patient with head injury among those having CT scan done early as compare to those who have delay in CT scan and to recognize multiple in-hospital factors associated with head injury management that can predict better outcome. This was a prospective cohort study in which a cohort of pediatric patients with head injury secondary to mechanical trauma was enrolled at the time of presentation to the emergency department within 24 hour. Three major tertiary care hospitals of Karachi were included. Follow up was done for 30 days to see the outcome. The mean age of pediatric patients presented with head injury was 7.03 (5.46, 8.60). Out of 288 participants, there was male predominance with 203 (70.4%). Majority of cases 61 (64.8%) used non ambulance mode of transport to reached hospital. Another finding include with every one hour of delay in CT scan hazard of mortality increase by 7.42 (CI, 2.26, 24.3) along with GCS and maintenance of circulation. To summarize, the more delay in CT scan will put patient more at risk of having worst outcome as compare to those having CT scan done as early as possible. Patient GCS score is a strong predictor of clinical outcome along with timely management of maintaining circulation may result in better outcome.