K. Hanna1, M. Hamidi1, A. Tang1, E. Zakaria1, N. Kulvatunyou1, A. Northcutt1, L. Gries1, T. O’Keeffe1, B. Joseph1 1University Of Arizona,Trauma And Acute Care Surgery,Tucson, AZ, USA
Introduction:
Organ dysfunction commonly occurs after traumatic brain injury (TBI) and is associated with increased mortality. The aim of our study was to evaluate the prevalence of non-neurologic organ dysfunction and its association with outcomes in pediatric patients with isolated severe TBI.
Methods:
We performed a 4-year (2013-16) analysis of our prospectively maintained TBI database. All pediatric (age<18) trauma patients with a severe isolated-TBI (head-AIS≥3 and other body region-AIS<3) were included. Non-neurologic organ dysfunction was measured by the pediatric multiple organ dysfunction (P-MOD) score. Organ failure was defined as a P-MOD component score of >3 anytime during the patient stay in the hospital. Regression analysis was performed to control for confounders.
Results:
We analyzed 210 isolated TBI patients. Mean age was 11±6, 57% were male and the mortality rate was 18.1%. Median ICU and hospital stays were 12 [6-20] and 8 [2-9] respectively. A total of 96 organ system dysfunctions were identified in 74 patients. Single organ-system dysfunction was present in 51 patients (Table 1). The most common system involved was cardiovascular (16%) followed by respiratory (8.1%). On regression, the presence of any non-neurologic organ dysfunction was independently associated with in-hospital mortality (OR, 2.2[2.1-4.5]) (Figure 1).
Conclusion:
Non-neurologic organ dysfunction develops in one of every three severe TBI patients and is independently associated with adverse outcomes in pediatric patients. Identification of non-neurologic organ dysfunctions in isolated pediatric TBI and focusing on management of non-neurologic organ dysfunction may lead to improved outcomes.
