Table 1.
Clinical and Outcome Characteristics of 234 Children with Severe Traumatic Brain Injury across Five Study Centers Categorized by Early (pre-hospital or emergency department) Hypotension. Hypotension is defined as systolic blood pressure (SBP) < 70 + 2 (Age) according to 2003 BTF guidelines.10 Data expressed as column percent. Two children had blood pressure missing from early care documentation.
| Clinical Characteristics | Early Hypotension (N = 60) | No Early Hypotension N=174 N (%) |
|
|---|---|---|---|
| No treatment N=5 N (%) |
Treatment N=55 N (%) |
||
| Age (years) [SD] | 5.8 [6.9] | 10.6 [6.5] | 7.4 [6.0] |
| Gender | |||
| Male | 3 (60.0) | 34 (61.8) | 125 (71.8) |
| Injury Severity Score (mean) [SD] | 28.6 [7.1] | 35.7 [15.7] | 26.1 [11.0] |
| Head Abbreviated Injury Severity (AIS) Score | |||
| 3 | 0 (0.0) | 5 (9.1) | 22 (12.6) |
| 4 | 2 (40.0) | 17 (30.9) | 60 (34.5) |
| 5 | 3 (60.0) | 31 (56.4) | 91 (52.3) |
| 6 | 0 (0.0) | 2 (3.6) | 1 (0.6) |
| Highest Non-Head Abbreviated Injury Severity (AIS) Score | |||
| 0 | 0 (0.0) | 5 (9.1) | 48 (27.6) |
| 1 | 3 (60.0) | 12 (21.8) | 43 (24.7) |
| 2 | 0 (0.0) | 6 (10.9) | 30 (17.2) |
| 3 | 2 (40.0) | 17 (30.9) | 40 (23.0) |
| 4 | 0 (0.0) | 10 (18.2) | 12 (6.9) |
| 5 | 0 (0.0) | 5 (9.1) | 0 (0.0) |
| 6 | 0 (0.0) | 0 (0.0) | 1 (0.6) |
| Admit Glasgow Coma Scale (GCS) score (motor) | |||
| 1, paralyzed | 0 (0.0) | 36 (65.4) | 61 (35.1) |
| 1, not paralyzed | 1 (20.0) | 3 (5.5) | 16 (9.2) |
| 2 | 1 (20.0) | 1 (1.8) | 8 (4.6) |
| 3 | 1 (20.0) | 5 (9.1) | 15 (8.6) |
| 4 | 0 (0.0) | 6 (10.9) | 37 (21.3) |
| 5 | 2 (40.0) | 4 (7.3) | 33 (19.0) |
| 6 | 0 (0.0) | 0 (0.0) | 4 (2.3) |
| Extracranial Injuries | 5 (100.0) | 46 (83.6) | 118 (67.8) |
| Extracranial Injury location | |||
| Face | 5 (100.0) | 28 (50.9) | 73 (42.0) |
| Neck | 1 (20.0) | 4 (7.3) | 5 (2.9) |
| Thorax | 2 (40.0) | 28 (50.9) | 36 (20.7) |
| Abdomen | 2 (40.0) | 20 (36.4) | 26 (14.9) |
| Spine | 0 (0.0) | 9 (16.4) | 11 (6.3) |
| Extremities | 3 (60.0) | 30 (54.6) | 79 (45.4) |
| All Head Computed Tomography Diagnoses | |||
| Epidural Hematoma | 1 (20.0) | 9 (16.4) | 30 (17.2) |
| Subdural Hematoma | 4 (80.0) | 34 (61.8) | 117 (67.2) |
| Subarachnoid Hemorrhage | 2 (40.0) | 32 (58.2) | 73 (42.0) |
| Intracerebral Hemorrhage | 0 (0.0) | 20 (36.4) | 53 (30.5) |
| Intraventricular Hemorrhage | 2 (40.0) | 11 (20.0) | 34 (19.5) |
| Cerebral Edema | 5 (100.0) | 31 (56.4) | 90 (51.7) |
| Cerebral Infarction | 2 (40.0) | 3 (5.4) | 32 (18.4) |
| Contusion | 2 (40.0) | 23 (41.8) | 69 (39.7) |
| Diffuse Axonal | 3 (60.0) | 20 (36.4) | 47 (27.0) |
| Any High Intracranial Pressure | 5 (100.0) | 42 (76.4) | 145 (83.3) |
| Any Surgery | 4 (80.0) | 35 (63.6) | 111 (63.8) |
| Outcome Characteristics | Early Hypotension (N = 60) |
No Early Hypotension N=174 N (%) |
|
|
No treatment N=5 N (%) |
Treatment N=55 N (%) |
||
| ICU Length of Stay (days) mean[SD] | 17.2 [13.9] | 15.4 [13.4] | 14.5 [11.8] |
| In-hospital Mortality | 3 (60.0) | 11 (20.0) | 15 (8.6) |
| Discharge Glasgow outcome scale (GOS) score (alive) | N = 2 | N = 44 | N = 159 |
| Poor (vegetative state/major impairment) | 2 (100.0) | 32 (72.7) | 99 (62.3) |
| Favorable (minor-moderate. impairment/baseline functioning) | 0 (0.0) | 12 (27.3) | 60 (37.7) |