A Multicenter Study on the Clinical Characteristics and Outcomes Among Children With Moderate to Severe Abusive Head Trauma
Copyright © 2023 Elsevier Inc. All rights reserved..
INTRODUCTION: We aimed to identify clinical characteristics, risk factors for diagnosis, and describe outcomes among children with AHT.
METHODS: We performed an observational cohort study in tertiary care hospitals from 14 countries across Asia and Ibero-America. We included patients <5 years old who were admitted to participating pediatric intensive care units (PICUs) with moderate to severe traumatic brain injury (TBI). We performed descriptive analysis and multivariable logistic regression for risk factors of AHT.
RESULTS: 47 (12%) out of 392 patients were diagnosed with AHT. Compared to those with accidental injuries, children with AHT were more frequently < 2 years old (42, 89.4% vs 133, 38.6%, p < 0.001), more likely to arrive by private transportation (25, 53.2%, vs 88, 25.7%, p < 0.001), but less likely to have multiple injuries (14, 29.8% vs 158, 45.8%, p = 0.038). The AHT group was more likely to suffer subdural hemorrhage (SDH) (39, 83.0% vs 89, 25.8%, p < 0.001), require antiepileptic medications (41, 87.2% vs 209, 60.6%, p < 0.001), and neurosurgical interventions (27, 57.40% vs 143, 41.40%, p = 0.038). Mortality, PICU length of stay, and functional outcomes at 3 months were similar in both groups. In the multivariable logistic regression, age <2 years old (aOR 8.44, 95%CI 3.07-23.2), presence of seizures (aOR 3.43, 95%CI 1.60-7.36), and presence of SDH (aOR 9.58, 95%CI 4.10-22.39) were independently associated with AHT.
CONCLUSIONS: AHT diagnosis represented 12% of our TBI cohort. Overall, children with AHT required more neurosurgical interventions and the use of anti-epileptic medications. Children younger than 2 years and with SDH were independently associated with a diagnosis of AHT.
TYPE OF STUDY: Observational cohort study.
LEVEL OF EVIDENCE: III.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:59 |
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| Enthalten in: |
Journal of pediatric surgery - 59(2024), 3 vom: 01. Feb., Seite 494-499 |
| Sprache: |
Englisch |
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| Links: |
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| Themen: |
Abusive head trauma |
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| Anmerkungen: |
Date Completed 14.02.2024 Date Revised 14.02.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.jpedsurg.2023.09.038 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM363593691 |
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| 100 | 1 | |a Yock-Corrales, Adriana |e verfasserin |4 aut | |
| 245 | 1 | 2 | |a A Multicenter Study on the Clinical Characteristics and Outcomes Among Children With Moderate to Severe Abusive Head Trauma |
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| 500 | |a Date Revised 14.02.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 Elsevier Inc. All rights reserved. | ||
| 520 | |a INTRODUCTION: We aimed to identify clinical characteristics, risk factors for diagnosis, and describe outcomes among children with AHT | ||
| 520 | |a METHODS: We performed an observational cohort study in tertiary care hospitals from 14 countries across Asia and Ibero-America. We included patients <5 years old who were admitted to participating pediatric intensive care units (PICUs) with moderate to severe traumatic brain injury (TBI). We performed descriptive analysis and multivariable logistic regression for risk factors of AHT | ||
| 520 | |a RESULTS: 47 (12%) out of 392 patients were diagnosed with AHT. Compared to those with accidental injuries, children with AHT were more frequently < 2 years old (42, 89.4% vs 133, 38.6%, p < 0.001), more likely to arrive by private transportation (25, 53.2%, vs 88, 25.7%, p < 0.001), but less likely to have multiple injuries (14, 29.8% vs 158, 45.8%, p = 0.038). The AHT group was more likely to suffer subdural hemorrhage (SDH) (39, 83.0% vs 89, 25.8%, p < 0.001), require antiepileptic medications (41, 87.2% vs 209, 60.6%, p < 0.001), and neurosurgical interventions (27, 57.40% vs 143, 41.40%, p = 0.038). Mortality, PICU length of stay, and functional outcomes at 3 months were similar in both groups. In the multivariable logistic regression, age <2 years old (aOR 8.44, 95%CI 3.07-23.2), presence of seizures (aOR 3.43, 95%CI 1.60-7.36), and presence of SDH (aOR 9.58, 95%CI 4.10-22.39) were independently associated with AHT | ||
| 520 | |a CONCLUSIONS: AHT diagnosis represented 12% of our TBI cohort. Overall, children with AHT required more neurosurgical interventions and the use of anti-epileptic medications. Children younger than 2 years and with SDH were independently associated with a diagnosis of AHT | ||
| 520 | |a TYPE OF STUDY: Observational cohort study | ||
| 520 | |a LEVEL OF EVIDENCE: III | ||
| 650 | 4 | |a Observational Study | |
| 650 | 4 | |a Multicenter Study | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Abusive head trauma | |
| 650 | 4 | |a Child | |
| 650 | 4 | |a Infant | |
| 650 | 4 | |a Neurocritical care | |
| 700 | 1 | |a Lee, Jan Hau |e verfasserin |4 aut | |
| 700 | 1 | |a Domínguez-Rojas, Jesús Ángel |e verfasserin |4 aut | |
| 700 | 1 | |a Caporal, Paula |e verfasserin |4 aut | |
| 700 | 1 | |a Roa, Juan D |e verfasserin |4 aut | |
| 700 | 1 | |a Fernandez-Sarmiento, Jaime |e verfasserin |4 aut | |
| 700 | 1 | |a González-Dambrauskas, Sebastián |e verfasserin |4 aut | |
| 700 | 1 | |a Zhu, Yanan |e verfasserin |4 aut | |
| 700 | 1 | |a Abbas, Qalab |e verfasserin |4 aut | |
| 700 | 1 | |a Kazzaz, Yasser |e verfasserin |4 aut | |
| 700 | 1 | |a Dewi, Dianna Sri |e verfasserin |4 aut | |
| 700 | 1 | |a Chong, Shu-Ling |e verfasserin |4 aut | |
| 700 | 0 | |a Pediatric Acute and Critical Care Medicine Asian Network (PACCMAN) and Red Colaborativa Pediátrica de Latino America (LARed) Networks |e verfasserin |4 aut | |
| 700 | 1 | |a Lee, Jan Hau |e investigator |4 oth | |
| 700 | 1 | |a Liu, Jun |e investigator |4 oth | |
| 700 | 1 | |a Chor, Yek Kee |e investigator |4 oth | |
| 700 | 1 | |a Gan, Chin Seng |e investigator |4 oth | |
| 700 | 1 | |a Ong, Jacqueline |e investigator |4 oth | |
| 700 | 1 | |a Anantasit, Nattachai |e investigator |4 oth | |
| 700 | 1 | |a Samransamruajkit, Rujipat |e investigator |4 oth | |
| 700 | 1 | |a Kurosawa, Hiroshi |e investigator |4 oth | |
| 700 | 1 | |a Ming, Mei Xiu |e investigator |4 oth | |
| 700 | 1 | |a Dang, Hongxing |e investigator |4 oth | |
| 700 | 1 | |a Abbas, Qalab |e investigator |4 oth | |
| 700 | 1 | |a Lee, Pei-Chuen |e investigator |4 oth | |
| 700 | 1 | |a Liu, Chunfeng |e investigator |4 oth | |
| 700 | 1 | |a Kazzaz, Yasser M |e investigator |4 oth | |
| 700 | 1 | |a González-Dambrauskas, Sebastián |e investigator |4 oth | |
| 700 | 1 | |a Roa G, Juan D |e investigator |4 oth | |
| 700 | 1 | |a Fernández-Sarmiento, Jaime |e investigator |4 oth | |
| 700 | 1 | |a Gómez Arriola, Natalia Elizabeth |e investigator |4 oth | |
| 700 | 1 | |a Ardila Gómez, Ivan Jose |e investigator |4 oth | |
| 700 | 1 | |a Jaramillo Bustamante, Juan Camilo |e investigator |4 oth | |
| 700 | 1 | |a Caporal, Paula |e investigator |4 oth | |
| 700 | 1 | |a Aparicio, Gabriela |e investigator |4 oth | |
| 700 | 1 | |a Pantoja Chamorro, Freddy Israel |e investigator |4 oth | |
| 700 | 1 | |a Terán Miranda, Thelma Elvira |e investigator |4 oth | |
| 700 | 1 | |a Flores, Marisol Fonseca |e investigator |4 oth | |
| 700 | 1 | |a Torre Gómez, Rosa Elena de la |e investigator |4 oth | |
| 700 | 1 | |a Pilar Orive, Francisco Javier |e investigator |4 oth | |
| 700 | 1 | |a Lasso Palomino, Rubén Eduardo |e investigator |4 oth | |
| 700 | 1 | |a Watzlawik, Natalia Zita |e investigator |4 oth | |
| 700 | 1 | |a Yock-Corrales, Adriana |e investigator |4 oth | |
| 700 | 1 | |a Guier-Bonilla, Luisana |e investigator |4 oth | |
| 700 | 1 | |a Turina, Deborah M |e investigator |4 oth | |
| 700 | 1 | |a Rodríguez, María Miñambres |e investigator |4 oth | |
| 700 | 1 | |a Domínguez Rojas, Jesús Ángel |e investigator |4 oth | |
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