Prognostic Factors of Severe Traumatic Brain Injury Outcome in Children Aged 2-16 Years at A Major Neurosurgical Referral Centre

Background: Traumatic Brain Injury (TBI) in children has been poorly studied, and the literature is limited. We evaluated 146 children with severe TBI ( coma score less than 8) in an attempt to establish the prognostic factors of severe TBI in children. Methods: The severity of TBI was assessed via modified Glasgow Coma Score for those more than 3 years old and via Children Coma Score for those under 3 years old. Clinical presentations, laboratory parameters and features of Computerised Tomography brain scans were analyzed. Outcomes were assessed at 6 months with the Pediatric Cerebral Performance Categories Scale; the outcomes were categorised as good or poor outcomes. Correlations with outcome were evaluated using univariate and multivariate logistic models. Results: A low coma score upon admission was independently associated with poor outcome. The presence of diabetes insipidus within 3 days post-TBI (OR: 1.9), hyperglycaemia (OR: 1.2), prolonged PT ratio (OR: 2.3) and leukocytosis (OR: 1.1) were associated with poorer outcome. Conclusion: Knowledge of these prognostic factors helps neurosurgeons and neurocritical care specialists to manage and improve outcome in severe TBI in children.