Academic Journal
Clinical and Physiologic Factors Associated With Mode of Death in Pediatric Severe TBI
| العنوان: | Clinical and Physiologic Factors Associated With Mode of Death in Pediatric Severe TBI |
|---|---|
| المؤلفون: | Baird, Talia D., Miller, Michael R., Cameron, Saoirse, Fraser, Douglas D., Tijssen, Janice A. |
| المصدر: | Frontiers in Pediatrics ; volume 9 ; ISSN 2296-2360 |
| بيانات النشر: | Frontiers Media SA |
| سنة النشر: | 2021 |
| المجموعة: | Frontiers (Publisher - via CrossRef) |
| الوصف: | Aims and Objectives: Severe traumatic brain injury (sTBI) is the leading cause of death in children. Our aim was to determine the mode of death for children who died with sTBI in a Pediatric Critical Care Unit (PCCU) and evaluate factors associated with mortality. Methods: We performed a retrospective cohort study of all severely injured trauma patients (Injury Severity Score ≥ 12) with sTBI (Glasgow Coma Scale [GCS] ≤ 8 and Maximum Abbreviated Injury Scale ≥ 4) admitted to a Canadian PCCU (2000–2016). We analyzed mode of death, clinical factors, interventions, lab values within 24 h of admission (early) and pre-death (48 h prior to death), and reviewed meeting notes in patients who died in the PCCU. Results: Of 195 included patients with sTBI, 55 (28%) died in the PCCU. Of these, 31 (56%) had a physiologic death (neurologic determination of death or cardiac arrest), while 24 (44%) had withdrawal of life-sustaining therapies (WLST). Median (IQR) times to death were 35.2 (11.8, 86.4) hours in the physiologic group and 79.5 (17.6, 231.3) hours in the WLST group ( p = 0.08). The physiologic group had higher partial thromboplastin time (PTT) within 24 h of admission ( p = 0.04) and lower albumin prior to death ( p = 0.04). Conclusions: Almost half of sTBI deaths in the PCCU were by WLST. There was a trend toward a longer time to death in these patients. We found few early and late (pre-death) factors associated with mode of death, namely higher PTT and lower albumin. |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | unknown |
| DOI: | 10.3389/fped.2021.793008 |
| DOI: | 10.3389/fped.2021.793008/full |
| الاتاحة: | http://dx.doi.org/10.3389/fped.2021.793008 https://www.frontiersin.org/articles/10.3389/fped.2021.793008/full |
| Rights: | https://creativecommons.org/licenses/by/4.0/ |
| رقم الانضمام: | edsbas.7D1F9F73 |
| قاعدة البيانات: | BASE |
| DOI: | 10.3389/fped.2021.793008 |
|---|