Department of Radiology, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand.
Department of Radiology, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand.
Chin J Traumatol. 2024 Dec;27(6):334-339. doi: 10.1016/j.cjtee.2024.03.003. Epub 2024 Mar 7.
Traumatic brain injury (TBI) can cause significant morbidity and mortality in the pediatric population. Brain CT is the mainstay in the diagnosis of intracranial hemorrhage (ICH). The aim of this study was to explore the clinical characteristics that can predict ICH on brain CT in pediatric TBI patients, to assist physicians in deciding on the use of brain CT.
A total of 475 pediatric TBI patients who underwent brain CT within 24 h after injury from January 2012 to December 2021 in the level 1 trauma center in Thailand were included in this cross-sectional study. Clinical data and brain CT findings were collected. Logistic regression analysis was applied to evaluate clinical characteristics that could predict ICH on brain CT in pediatric TBI patients. A p value was less than 0.05 being indicated that the difference is statistically significant. R software version 3.6.1 was used to statistical analysis.
The included cases have a median (Q, Q) age of 7.7 (3.5, 12.6) years. ICH was found in 98 (20.6%) pediatric patients based on brain CT findings. On multivariable analysis, high blunt energy injury (odds ratio (OR) = 2.79, 95% CI 1.27 - 6.11, p = 0.010), motor vehicle accidents (OR = 2.04, 95% CI: 1.14 - 3.67, p = 0.017), Glasgow coma scale score <13 (OR = 4.28, 95% CI: 1.87 - 9.78, p < 0.001), palpable skull fractures (OR = 7.30, 95% CI: 1.44 - 37.04, p = 0.016), signs of basilar skull fracture (OR = 6.10, 95% CI: 2.16 - 17.24, p < 0.001), and vomiting ≥ 3 times (OR = 2.60, 95% CI: 1.17 - 5.77, p = 0.022) were statistically significant predictive factors for ICH in pediatric TBI patients.
These factors might aid clinicians in making an appropriate decision regarding the use of brain CT in pediatric TBI cases.
创伤性脑损伤（TBI）可导致儿科人群的发病率和死亡率显著增加。脑 CT 是诊断颅内出血（ICH）的主要手段。本研究旨在探讨能够预测儿科 TBI 患者脑 CT 上 ICH 的临床特征，以帮助医生决定是否使用脑 CT。
本回顾性研究共纳入 2012 年 1 月至 2021 年 12 月在泰国 1 级创伤中心接受伤后 24 小时内脑 CT 检查的 475 例儿科 TBI 患者。收集临床数据和脑 CT 表现。应用逻辑回归分析评估可能预测儿科 TBI 患者脑 CT 上 ICH 的临床特征。p 值小于 0.05 表示差异具有统计学意义。使用 R 软件版本 3.6.1 进行统计分析。
纳入病例的中位（Q，Q）年龄为 7.7（3.5，12.6）岁。根据脑 CT 结果，98 例（20.6%）儿科患者发现 ICH。多变量分析显示，高钝性能量损伤（比值比（OR）=2.79，95%CI 1.27-6.11，p=0.010）、机动车事故（OR=2.04，95%CI：1.14-3.67，p=0.017）、格拉斯哥昏迷量表评分<13（OR=4.28，95%CI：1.87-9.78，p<0.001）、可触及颅骨骨折（OR=7.30，95%CI：1.44-37.04，p=0.016）、颅底骨折征象（OR=6.10，95%CI：2.16-17.24，p<0.001）和呕吐≥3 次（OR=2.60，95%CI：1.17-5.77，p=0.022）是儿科 TBI 患者发生 ICH 的统计学显著预测因素。
这些因素可能有助于临床医生在决定是否对儿科 TBI 患者使用脑 CT 时做出适当的决策。
