Prediction of discharge destination after traumatic brain injury in children using the head abbreviated injury scale

Introduction: Traumatic brain injury (TBI) is a major public health problem, particularly in children. Prognostication of injury severity at the time of presentation is difficult. The Abbreviated Injury Scale (AIS) is a commonly used anatomical-based coding system created to classify and describe in...

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Bibliographic Details
Published in:Brain injury 2019-04, Vol.33 (5), p.643-648
Main Authors: Hubbard, Molly E., Bin Zahid, Abdullah, Vonderhaar, Kathleen, Freeman, David, Nygaard, Rachel M., Kiragu, Andrew, Guillaume, Daniel
Format: Article
Language:English
Subjects:
Abbreviated Injury Scale
Adolescent
Brain Injuries, Traumatic - diagnosis
Brain Injuries, Traumatic - therapy
Child
Child, Preschool
discharge destination
Female
Humans
Male
Neurological Rehabilitation
Patient Discharge
pediatric head trauma
Prognosis
Registries
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Summary:Introduction: Traumatic brain injury (TBI) is a major public health problem, particularly in children. Prognostication of injury severity at the time of presentation is difficult. The Abbreviated Injury Scale (AIS) is a commonly used anatomical-based coding system created to classify and describe injury severity after initial presentation, once test results are able to better define the anatomical characteristics of the injury. We hypothesize that the Head AIS can predict discharge destination in children after TBI. Methods: The trauma registry database for a Pediatric Level 1 Trauma center was queried for patients age ≤14 years from 2006 to 2015 with a Head AIS>2. All diagnoses with head AIS>2 were retrieved. Since one patient can have multiple diagnoses with an AIS>2, we selected the diagnosis with highest Head AIS associated with each patient. The demographics, length of stay, and the discharge disposition of patients were retrieved. Descriptive statistics were performed and association of Head AIS with the length of stay and discharge disposition was determined using logistic regression. Results: 393 pediatric patients (age≤14 years) with an Head AIS ≥3, (64.0% males, mean age = 6.2 S.D. 4.58) presented over 10 years. Head AIS was strongly associated with mortality; with 0.8%, 1.1% and 42.0% of patients with Head AIS of 3, 4 and 5, respectively, dying - odds ratio for Head AIS 5 over Head AIS 3 = 89 (logistic regression, p-value
ISSN:0269-9052
1362-301X
DOI:10.1080/02699052.2019.1566966