Background: Traumatic Brain Injury (TBI) in children has been poorly studied, and the
literature is limited. We evaluated 146 children with severe TBI (coma score less than 8) in an attempt
to establish the prognostic factors of severe TBI in children.
Methods: The severity of TBI was assessed via modified Glasgow Coma Score for those more than
3 years old and via Children Coma Score for those under 3 years old. Clinical presentations, laboratory
parameters and features of Computerised Tomography brain scans were analyzed. Outcomes were
assessed at 6 months with the Pediatric Cerebral Performance Categories Scale; the outcomes were
categorised as good or poor outcomes. Correlations with outcome were evaluated using univariate and
multivariate logistic models.
Results: A low coma score upon admission was independently associated with poor outcome. The
presence of diabetes insipidus within 3 days post-TBI (OR: 1.9), hyperglycaemia (OR: 1.2), prolonged
PT ratio (OR: 2.3) and leukocytosis (OR: 1.1) were associated with poorer outcome.
Conclusion: Knowledge of these prognostic factors helps neurosurgeons and neurocritical care
specialists to manage and improve outcome in severe TBI in children.
