Early prediction of outcome following head injury in children

• Published in: Journal of pediatric surgery Vol. 22; no. 2; pp. 127 - 129
• Main Authors: Wagstyl, J., Sutcliffe, Anne J., Alpar, E.K.
• Format: Journal Article
• Language: English
• Published: Philadelphia, PA Elsevier Inc 01.02.1987; Elsevier
• Subjects: Adolescent; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Child; Child, Preschool; Coma - diagnosis; Coma - etiology; Craniocerebral Trauma - complications; Craniocerebral Trauma - diagnosis; Craniocerebral Trauma - mortality; Emergency and intensive care: neonates and children. Prematurity. Sudden death; Female; Humans; Infant; Intensive care medicine; Male; Medical sciences; Prognosis; Reflex, Abnormal - complications; Retrospective Studies; Skull Fractures - complications; Thoracic Injuries - complications; Time Factors; Head injury; Human; Nervous system diseases; Prognosis; Craniocerebral; Index; Child; Trauma; Resuscitation
• ISSN: 0022-3468; 1531-5037
• DOI: 10.1016/S0022-3468(87)80427-X

A retrospective survey of 166 children aged 15 years or less was made in an attempt to identify which clinical features presenting in the first 24 hours after a head injury might be helpful in predicting the eventual outcome as defined by the Glasgow Outcome Scale. In 88% of the children, the trend of Glasgow Coma Scale score over the first 24 hours was useful. This included children admitted with a score of 3 or 5 and those with a score of 5 or more who did not deteriorate within 24 hours of injury. In this group only 2% of the predictions would have been inaccurate and in only 0.7% would the outcome have been worse than the prediction. The presence of both abnormal plantar and pupillary light reflexes predicted death or significant disability in 99% of cases.