Predictors of poor outcome of decompressive craniectomy in pediatric patients with severe traumatic brain injury: A retrospective single center study from Pakistan

Saad Akhtar Khan, Hussain Shallwani, Muhammad Shahzad Shamim, Ghulam Murtaza, Syed Ather Enam, Reema Obaid Qureshi, Muhammad Zubair Tahir

Research output: Contribution to journalArticlepeer-review

15 Citations (Scopus)

Abstract

Objective: This study aimed to determine the risk factors associated with poor outcome of decompressive craniectomy (DC) for severe traumatic brain injury (TBI) in pediatric patients. Methods: This retrospective study is conducted on pediatric population (age 1-15 years) presenting with TBI who underwent DC at our institute between January 2000 and 2010. Based on Glasgow outcome score (GOS) at a minimum follow-up of 5 months, patients were divided into two groups, namely poor outcome (GOS 1, 2, and 3) and good outcome (GOS 4 and 5). Records were reviewed and analyzed for preoperative and intraoperative predictors. Results: We found 25 patients who were eligible as per selection criteria. Mean age at presentation was 6 ± 4 years and there was male preponderance (84 %). Fall (60 %) was the most common mechanism of injury followed by gunshots and road traffic accident. On univariate analysis, presenting GCS ≤5 (p value = 0.009), delay in presentation of more than 150 min (p value = 0.010), DC performed after more than 4 h of arrival in hospital (p value = 0.042), and intraoperative blood loss exceeding 300 ml (p value = 0.001) were significant predictors of poor outcome. Conclusion: Our study suggests that DC in children is not only a life-saving procedure, but also leads to a good functional outcome after severe injury. However, patient selection still remains an important aspect, and the above-mentioned factors should be considered while deciding for DC to improve survival. Further prospective studies on larger sample size are warranted to validate our results.

Original languageEnglish
Pages (from-to)277-281
Number of pages5
JournalChild's Nervous System
Volume30
Issue number2
DOIs
Publication statusPublished - Feb 2014

Keywords

  • Decompressive craniectomy
  • Pediatric population
  • Traumatic brain injury

Fingerprint

Dive into the research topics of 'Predictors of poor outcome of decompressive craniectomy in pediatric patients with severe traumatic brain injury: A retrospective single center study from Pakistan'. Together they form a unique fingerprint.

Cite this