Early posttraumatic seizures in pediatric traumatic brain injury: A multicenter analysis
OBJECTIVE Early posttraumatic seizures (EPTSs) in children after traumatic brain injury (TBI) increase metabolic stress on the injured brain. The authors sought to study the demographic and radiographic predictors for EPTS, and to investigate the association between EPTS and death, and between EPTS...
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2022
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my.um.eprints.333952022-08-03T03:40:12Z http://eprints.um.edu.my/33395/ Early posttraumatic seizures in pediatric traumatic brain injury: A multicenter analysis Chong, Shu-Ling Qian, Suyun Yao, Sarah Hui Wen Allen, John Carson Dang, Hongxing Chan, Lawrence C. N. Ming, Meixiu Gan, Chin Seng Ong, Jacqueline S. M. Kurosawa, Hiroshi Lee, Jan Hau A, Pediat Acute Critical Care Med RD Surgery RJ Pediatrics OBJECTIVE Early posttraumatic seizures (EPTSs) in children after traumatic brain injury (TBI) increase metabolic stress on the injured brain. The authors sought to study the demographic and radiographic predictors for EPTS, and to investigate the association between EPTS and death, and between EPTS and poor functional outcomes among children with moderate to severe TBI in Asia. METHODS A secondary analysis of a retrospective TBI cohort among participating centers of the Pediatric Acute & Critical Care Medicine Asian Network was performed. Children < 16 years of age with a Glasgow Coma Scale (GCS) score <= 13 who were admitted to pediatric intensive care units between January 2014 and October 2017 were included. Logistic regression analysis was performed to study risk factors for EPTS and to investigate the association between EPTS and death, and between EPTS and poor functional outcomes. Poor functional outcomes were defined as moderate disability, severe disability, and coma as defined by the Pediatric Cerebral Performance Category scale. RESULTS Overall, 313 children were analyzed, with a median age of 4.3 years (IQR 1.8-8.9 years); 162 children (51.8%) had severe TBI (GCS score < 8), and 76 children (24.3%) had EPTS. After adjusting for age, sex, and the presence of nonaccidental trauma (NAT), only younger age was significantly associated with EPTS (adjusted odds ratio aOR] 0.85, 95% CI 0.78-0.92; p < 0.001). Forty-nine children (15.6%) in the cohort died, and 87 (32.9%) of the 264 surviving patients had poor functional outcomes. EPTS did not increase the risk of death. After adjusting for age, sex, TBI due to NAT, multiple traumas, and a GCS score < 8, the presence of EPTS was associated with poor functional out CONCLUSIONS EPTSs were common among children with moderate to severe TBI in Asia and were associated with poor functional outcomes among children who survived TBI. Amer Assoc Neurological Surgeons 2022-02 Article PeerReviewed Chong, Shu-Ling and Qian, Suyun and Yao, Sarah Hui Wen and Allen, John Carson and Dang, Hongxing and Chan, Lawrence C. N. and Ming, Meixiu and Gan, Chin Seng and Ong, Jacqueline S. M. and Kurosawa, Hiroshi and Lee, Jan Hau and A, Pediat Acute Critical Care Med (2022) Early posttraumatic seizures in pediatric traumatic brain injury: A multicenter analysis. Journal of Neurosurgery-Pediatrics, 29 (2). pp. 225-231. ISSN 1933-0707, DOI https://doi.org/10.3171/2021.8.PEDS21281 <https://doi.org/10.3171/2021.8.PEDS21281>. 10.3171/2021.8.PEDS21281 |
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RD Surgery RJ Pediatrics Chong, Shu-Ling Qian, Suyun Yao, Sarah Hui Wen Allen, John Carson Dang, Hongxing Chan, Lawrence C. N. Ming, Meixiu Gan, Chin Seng Ong, Jacqueline S. M. Kurosawa, Hiroshi Lee, Jan Hau A, Pediat Acute Critical Care Med Early posttraumatic seizures in pediatric traumatic brain injury: A multicenter analysis |
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OBJECTIVE Early posttraumatic seizures (EPTSs) in children after traumatic brain injury (TBI) increase metabolic stress on the injured brain. The authors sought to study the demographic and radiographic predictors for EPTS, and to investigate the association between EPTS and death, and between EPTS and poor functional outcomes among children with moderate to severe TBI in Asia. METHODS A secondary analysis of a retrospective TBI cohort among participating centers of the Pediatric Acute & Critical Care Medicine Asian Network was performed. Children < 16 years of age with a Glasgow Coma Scale (GCS) score <= 13 who were admitted to pediatric intensive care units between January 2014 and October 2017 were included. Logistic regression analysis was performed to study risk factors for EPTS and to investigate the association between EPTS and death, and between EPTS and poor functional outcomes. Poor functional outcomes were defined as moderate disability, severe disability, and coma as defined by the Pediatric Cerebral Performance Category scale. RESULTS Overall, 313 children were analyzed, with a median age of 4.3 years (IQR 1.8-8.9 years); 162 children (51.8%) had severe TBI (GCS score < 8), and 76 children (24.3%) had EPTS. After adjusting for age, sex, and the presence of nonaccidental trauma (NAT), only younger age was significantly associated with EPTS (adjusted odds ratio aOR] 0.85, 95% CI 0.78-0.92; p < 0.001). Forty-nine children (15.6%) in the cohort died, and 87 (32.9%) of the 264 surviving patients had poor functional outcomes. EPTS did not increase the risk of death. After adjusting for age, sex, TBI due to NAT, multiple traumas, and a GCS score < 8, the presence of EPTS was associated with poor functional out CONCLUSIONS EPTSs were common among children with moderate to severe TBI in Asia and were associated with poor functional outcomes among children who survived TBI. |
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Chong, Shu-Ling Qian, Suyun Yao, Sarah Hui Wen Allen, John Carson Dang, Hongxing Chan, Lawrence C. N. Ming, Meixiu Gan, Chin Seng Ong, Jacqueline S. M. Kurosawa, Hiroshi Lee, Jan Hau A, Pediat Acute Critical Care Med |
author_facet |
Chong, Shu-Ling Qian, Suyun Yao, Sarah Hui Wen Allen, John Carson Dang, Hongxing Chan, Lawrence C. N. Ming, Meixiu Gan, Chin Seng Ong, Jacqueline S. M. Kurosawa, Hiroshi Lee, Jan Hau A, Pediat Acute Critical Care Med |
author_sort |
Chong, Shu-Ling |
title |
Early posttraumatic seizures in pediatric traumatic brain injury: A multicenter analysis |
title_short |
Early posttraumatic seizures in pediatric traumatic brain injury: A multicenter analysis |
title_full |
Early posttraumatic seizures in pediatric traumatic brain injury: A multicenter analysis |
title_fullStr |
Early posttraumatic seizures in pediatric traumatic brain injury: A multicenter analysis |
title_full_unstemmed |
Early posttraumatic seizures in pediatric traumatic brain injury: A multicenter analysis |
title_sort |
early posttraumatic seizures in pediatric traumatic brain injury: a multicenter analysis |
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Amer Assoc Neurological Surgeons |
publishDate |
2022 |
url |
http://eprints.um.edu.my/33395/ |
_version_ |
1740826027682168832 |