Increased risk of death associated with hypotension is not altered by the presence of brain injury in pediatric trauma patients.

Authors:	Mark A Gunst, Jason L Sperry, Vafa Ghaemmaghami, Richard F Gunst, Randall S Friese, Heidi L Frankel, Larry M Gentilello, Shahid Shafi
Language:	Eng.
Date:	16-11-2007
Journal:	American Journal of Surgery (0002-9610)
Release:	Am J Surg. 2007 Dec;194(6):741-4; discussion 744-5
Abstract:	BACKGROUND: Hypotension is a well-known predictor of mortality in pediatric trauma patients. However, it is unknown whether the mortality rate is higher in patients with traumatic brain injury (TBI) than in those without TBI. We hypothesized that systemic hypotension increases mortality in pediatric patients with TBI more than it does in pediatric patients with extracranial injuries only. METHODS: Multivariate logistic regression was used to determine the relationship between hypotension and the risk of death. Patients were then divided into 2 groups: TBI and No-TBI and the model was applied separately to each group. RESULTS: Overall mortality was 2%. After adjusting for confounding variables, hypotension remained a strong independent predictor of mortality. However, the increased risk of death was similar in patients with and without TBI. CONCLUSION: Hypotension is an important predictor of death in pediatric trauma patients. The increased risk of death associated with hypotension is similar with or without traumatic brain injury.
Copyright:	American Journal of Surgery Division of Burns, Trauma and Surgical Critical Care, Department of Surgery, University of Texas Southwestern Medical School, 5323 Harry Hines Blvd, Dallas, TX 75390-9158, USA.
Full text:	American Journal of Surgery (DOI) EBSCO - HTML (needs subscription) Elsevier Science - HTML (needs subscription) MD Consult - HTML (needs subscription) Swets Information Services - HTML (needs subscription)
Terms:	Adolescent, Area Under Curve, Brain Injuries, Child, Child, Preschool, Female, Humans, Hypotension, Infant, Infant, Newborn, Logistic Models, Male, Odds Ratio, Risk Assessment