Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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Predictors of Outcome in Management of Paediatric Head Trauma in a Tertiary Healthcare Institution in North-Central Nigeria

  • Gyang Markus Bot (Division of Neurosurgery, Department of Surgery, Jos University Teaching Hospital) ;
  • Danaan J. Shilong (Division of Neurosurgery, Department of Surgery, Jos University Teaching Hospital) ;
  • Jerry A. Philip (Division of Neurosurgery, Department of Surgery, Jos University Teaching Hospital) ;
  • Ezekiel Dido Dung (Division of Paediatric Surgery, Department of Surgery, Jos University Teaching Hospital) ;
  • Andrew H. Shitta (Division of Paediatric Surgery, Department of Surgery, Jos University Teaching Hospital) ;
  • Nanpan Isa Kyesmen (Division of Neurosurgery, Department of Surgery, Jos University Teaching Hospital) ;
  • Jeneral D. Alfin (Division of Neurosurgery, Department of Surgery, Jos University Teaching Hospital) ;
  • Lena Mary Houlihan (The Loyal and Edith Davis Neurosurgical Research Laboratory, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center) ;
  • Mark C. Preul (The Loyal and Edith Davis Neurosurgical Research Laboratory, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center) ;
  • Kenneth N. Ozoilo (Division of Trauma Surgery, Department of Surgery, Jos University Teaching Hospital) ;
  • Peter O. Binitie (Division of Neurosurgery, Department of Surgery, Jos University Teaching Hospital)
  • Received : 2022.02.08
  • Accepted : 2022.10.12
  • Published : 2023.09.01
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Abstract

Objective : Trauma is a leading causes of death and disability in all ages. The aim of this study was to describe the demography and characteristics of paediatric head trauma in our institution and examine the predictors of outcome and incidence of injury related mortality. Methods : We examined our institutional Trauma Registry over a 2 year period. Results : A total of 1100 trauma patients were seen over the study period. Of the 579 patients who had head injury 99 were in the paediatric age group. Of the paediatric head trauma patients 79 had documented Glasgow coma score (GCS), 38 (48.1%), 17 (21.5%) and 24 (30.4%) had mild, moderate and severe head injury respectively. The percentage mortality of head injury in the paediatric age group was 6.06% (6/99). There is an association between mortality and GCS (p=0.008), necessity for intensive care unit (ICU) admission (p=0.0001), associated burns (p=0.0001) and complications such as aspiration pneumonia (p=0.0001). The significant predictors of outcome are aspiration (p=0.004), the need for ICU admission (p=0.0001) and associated burns (p=0.005) using logistic binary regression. During the study period 46 children underwent surgical intervention with extradural haematoma 16 (34.8%), depressed skull fracture 14 (30.4%) and chronic subdural haematoma five (10.9%) being the commonest indication for surgeries. Conclusion : Paediatric head injury accounted for 9.0% (99/1100) of all trauma admissions. Majority of patients had mild or moderate injuries. Burns, aspiration pneumonitis and the need for ICU admission were important predictors of outcome in children with traumatic brain injury.

Keywords

Acknowledgement

Thanks to the families with whom we worked. We wish to also thank Mr. Kopse Seyilnen for helping with the statistical analysis.

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