Outcome of head injury among paediatric patients in a tertiary care institute
Journal Title: Medpulse International Journal of Pediatrics - Year 2017, Vol 3, Issue 2
Abstract
Background: Head injury in children accounts for a large number of emergency department visits and hospital admissions and is reported to be the leading cause of death and disability in children around the world. The Center for Disease Control (CDC) and Prevention and the National Center for Injury Prevention and Control label traumatic brain injury (TBI) a “silent epidemic.” Objective: To study the outcome of head injury among paediatric patients reporting to a tertiary care institute. Materials and Method: All paediatric patients between ages one to 16 years, admitted with a history of head injury were included in the study. Children with underlying seizure disorder and with bleeding disorder were excluded from the study. Thus total 102 cases of head injury were enrolled in the present study. All patients were analyzed and classified according to their age, sex, pattern of injury, symptoms and examination findings at the time of presentation, CT Brain findings (if done), Glasgow Coma score. Patients managed in either pediatric ward or pediatric intensive care unit depending upon their severity and short term outcome analyzed at the time of discharge. Results: The incidence of head injury was more common in ≤ 5 years old children (45.1%). Fall from height was the most common cause (60.8%) of head injury in children followed by Accidents (25.5%), Strike against any object (10.8%) and Fights (2.9%). Good outcome was observed in 91 (89.22%) patients. Disability was observed in 7 (6.86%) patients. Case fatality rate of head injury was observed to be of 3.92%. Vomiting was the most common symptom following head injury. Vomiting and headache was not statistically significant as far as morbidity and mortality was concerned. Altered sensorium (0.008) was associated with poor outcome. All 4 patients who expired and 4 of who disabled had altered sensorium at the time of presentation. Seizures (0.007), depressed fracture (<0.001), associated injuries (<0.001), lacerations (<0.001) and swelling (0.03) were associated with poor outcome. Glasgow coma score ≤8 was associated with poor outcome. Presence of cerebral edema, extradural hematoma, subdural hematoma, contusions and cerebral herniation were more common in disabled and expired children. Surgical management was required only in 4 (3.92%) patients, rest of the patients were managed with medical treatment. Conclusion: Majority of the patients of head injury had good outcome. Disability was observed in 6.86% patients and case fatality rate of head injury was observed to be of 3.92%. Altered sensorium, Seizures, depressed fracture, associated injuries, lacerations, swelling and GCS ≤ 8 were associated with poor outcome. Presence of cerebral edema, extradural hematoma, subdural hematoma, contusions and cerebral herniation were more common in disabled and expired children
Authors and Affiliations
Ashwini Kundalwal, Uday Gajare, Rishikesh Pardeshi
Keywords
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