Outcomes of Repeat Surgery in Pediatric Severe Traumatic Brain Injury: An Analysis from Approaches and Decisions in Acute Pediatric Traumatic Brain Injury Trial
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作者:
Ahmed, Nasim
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机构:
Hackensack Meridian Sch Med, Dept Surg, Nutley, NJ 07110 USA
Jersey Shore Univ Med Ctr, Div Trauma & Surg Crit Care, Neptune, NJ 07753 USAHackensack Meridian Sch Med, Dept Surg, Nutley, NJ 07110 USA
Ahmed, Nasim
[1
,2
]
Russo, Larissa
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机构:
Jersey Shore Univ Med Ctr, Div Trauma, Neptune, NJ USAHackensack Meridian Sch Med, Dept Surg, Nutley, NJ 07110 USA
Russo, Larissa
[3
]
Kuo, Yen -Hong
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机构:
Jersey Shore Univ Med Ctr, Off Res Adm, Neptune, NJ USAHackensack Meridian Sch Med, Dept Surg, Nutley, NJ 07110 USA
Kuo, Yen -Hong
[4
]
机构:
[1] Hackensack Meridian Sch Med, Dept Surg, Nutley, NJ 07110 USA
[2] Jersey Shore Univ Med Ctr, Div Trauma & Surg Crit Care, Neptune, NJ 07753 USA
[3] Jersey Shore Univ Med Ctr, Div Trauma, Neptune, NJ USA
[4] Jersey Shore Univ Med Ctr, Off Res Adm, Neptune, NJ USA
Craniotomy/craniectomy;
Outcomes;
Repeat surgery;
Severe head injury;
ACUTE SUBDURAL-HEMATOMA;
EVACUATION;
D O I:
10.1016/j.wneu.2024.01.085
中图分类号:
R74 [神经病学与精神病学];
学科分类号:
摘要:
BACKGROUND: Early operative intervention, craniotomy, and/or craniectomy are occasionally warranted in severe traumatic brain injury (TBI). Persistent increased intracranial pressure or accumulation of intracranial hematoma postsurgery can result in higher mortality and morbidity. There is a gap in information regarding the outcome of repeat surgery (RS) in pediatric patients with severe TBI. METHODS: An observational cohort study titled Approaches and Decisions in Acute Pediatric TBI Trial data was obtained from the Federal Interagency Traumatic Brain Injury Research Informatics System. All pediatric patients who underwent craniotomy or decompressive craniectomy, survived more than 44 hours and were found to have persistent elevated intracranial pressure >20 mmHg for 2 consecutive hours were included in the study. The purpose of the study was to find the outcomes of RS in pediatric severe TBI. Propensity based matching was used to find the outcomes. The primary outcome was 60 -day mortality. RESULTS: Out of 1000 total patients enrolled in the Approaches and Decisions in Acute Pediatric Trial, 160 patients qualified for this study. Propensity score matching created 13 pairs of patients. There were no significant differences found between the groups who had RS versus those who did not have repeat surgery on baseline characteristics. There were no significant differences found between the groups regarding 60 -day mortality, median hospital days, median intensive care unit days, and 6month favorable outcome on Glasgow Outcome Scale Extended score. CONCLUSIONS: There was no difference in mortality between patients who underwent a second surgery and patients who did not have to undergo a second surgery.
机构:
Childrens Hosp Philadelphia, Div Emergency Med, Colket Translat Res Bldg,3501 Civ Ctr Blvd, Philadelphia, PA 19104 USA
Childrens Hosp Philadelphia, Ctr Injury Res & Prevent, Philadelphia, PA 19104 USAChildrens Hosp Philadelphia, Div Emergency Med, Colket Translat Res Bldg,3501 Civ Ctr Blvd, Philadelphia, PA 19104 USA
Corwin, Daniel J.
Grady, Matthew F.
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机构:
Childrens Hosp Philadelphia, Sports Med & Performance Ctr, Philadelphia, PA 19104 USA
Univ Penn, Perelman Sch Med, Clin Pediat, Philadelphia, PA 19104 USAChildrens Hosp Philadelphia, Div Emergency Med, Colket Translat Res Bldg,3501 Civ Ctr Blvd, Philadelphia, PA 19104 USA
Grady, Matthew F.
Joffe, Mark D.
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h-index: 0
机构:
Childrens Hosp Philadelphia, Div Emergency Med, Colket Translat Res Bldg,3501 Civ Ctr Blvd, Philadelphia, PA 19104 USA
Univ Penn, Perelman Sch Med, Pediat, Philadelphia, PA 19104 USAChildrens Hosp Philadelphia, Div Emergency Med, Colket Translat Res Bldg,3501 Civ Ctr Blvd, Philadelphia, PA 19104 USA
Joffe, Mark D.
Zonfrillo, Mark R.
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机构:
Brown Univ, Dept Emergency Med, Alpert Med Sch, Providence, RI 02912 USA
Brown Univ, Dept Pediat, Alpert Med Sch, Providence, RI 02912 USA
Hasbro Childrens Hosp, Providence, RI USAChildrens Hosp Philadelphia, Div Emergency Med, Colket Translat Res Bldg,3501 Civ Ctr Blvd, Philadelphia, PA 19104 USA
机构:
Murdoch Childrens Res Inst, Melbourne, Vic, Australia
Royal Childrens Hosp, Melbourne, Vic, Australia
Univ Melbourne, Dept Paediat, Melbourne, Vic, AustraliaMurdoch Childrens Res Inst, Melbourne, Vic, Australia
Sood, Nikita Tuli
Godfrey, Celia
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h-index: 0
机构:
Murdoch Childrens Res Inst, Melbourne, Vic, Australia
Royal Childrens Hosp, Melbourne, Vic, Australia
Univ Melbourne, Dept Paediat, Melbourne, Vic, AustraliaMurdoch Childrens Res Inst, Melbourne, Vic, Australia
Godfrey, Celia
Krasts, Daina
论文数: 0引用数: 0
h-index: 0
机构:
Murdoch Childrens Res Inst, Melbourne, Vic, AustraliaMurdoch Childrens Res Inst, Melbourne, Vic, Australia
Krasts, Daina
Morrison, Elle
论文数: 0引用数: 0
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机构:
Murdoch Childrens Res Inst, Melbourne, Vic, AustraliaMurdoch Childrens Res Inst, Melbourne, Vic, Australia
Morrison, Elle
Chavez Arana, Clara
论文数: 0引用数: 0
h-index: 0
机构:
Univ Rotterdam, Erasmus Sch Social & Behav Sci, Dept Psychol Educ & Child Studies, Rotterdam, NetherlandsMurdoch Childrens Res Inst, Melbourne, Vic, Australia
Chavez Arana, Clara
Hearps, Stephen J. C.
论文数: 0引用数: 0
h-index: 0
机构:
Murdoch Childrens Res Inst, Melbourne, Vic, Australia
Univ Melbourne, Dept Crit Care, Melbourne, Vic, AustraliaMurdoch Childrens Res Inst, Melbourne, Vic, Australia
Hearps, Stephen J. C.
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机构:
Anderson, Vicki
Catroppa, Cathy
论文数: 0引用数: 0
h-index: 0
机构:
Murdoch Childrens Res Inst, Melbourne, Vic, Australia
Royal Childrens Hosp, Melbourne, Vic, Australia
Univ Melbourne, Dept Paediat, Melbourne, Vic, Australia
Univ Melbourne, Melbourne Sch Psychol Sci, Melbourne, Vic, AustraliaMurdoch Childrens Res Inst, Melbourne, Vic, Australia
机构:
Univ Calif Los Angeles, David Geffen Sch Med, Brain Injury Res Ctr, Dept Neurosurg, Los Angeles, CA 90095 USA
Univ Calif Los Angeles, Steve Tisch BrainSPORT Program, Los Angeles, CA 90024 USAUniv Calif Los Angeles, David Geffen Sch Med, Brain Injury Res Ctr, Dept Neurosurg, Los Angeles, CA 90095 USA
Serpa, Rebecka O.
Ferguson, Lindsay
论文数: 0引用数: 0
h-index: 0
机构:
Univ Calif Los Angeles, David Geffen Sch Med, Brain Injury Res Ctr, Dept Neurosurg, Los Angeles, CA 90095 USA
Univ Calif Los Angeles, Steve Tisch BrainSPORT Program, Los Angeles, CA 90024 USAUniv Calif Los Angeles, David Geffen Sch Med, Brain Injury Res Ctr, Dept Neurosurg, Los Angeles, CA 90095 USA
Ferguson, Lindsay
Larson, Cooper
论文数: 0引用数: 0
h-index: 0
机构:
Univ Calif Los Angeles, David Geffen Sch Med, Brain Injury Res Ctr, Dept Neurosurg, Los Angeles, CA 90095 USA
Univ Calif Los Angeles, Steve Tisch BrainSPORT Program, Los Angeles, CA 90024 USAUniv Calif Los Angeles, David Geffen Sch Med, Brain Injury Res Ctr, Dept Neurosurg, Los Angeles, CA 90095 USA
Larson, Cooper
Bailard, Julie
论文数: 0引用数: 0
h-index: 0
机构:
Univ Calif Los Angeles, David Geffen Sch Med, Brain Injury Res Ctr, Dept Neurosurg, Los Angeles, CA 90095 USA
Univ Calif Los Angeles, Steve Tisch BrainSPORT Program, Los Angeles, CA 90024 USAUniv Calif Los Angeles, David Geffen Sch Med, Brain Injury Res Ctr, Dept Neurosurg, Los Angeles, CA 90095 USA
Bailard, Julie
Cooke, Samantha
论文数: 0引用数: 0
h-index: 0
机构:
Univ Calif Los Angeles, David Geffen Sch Med, Brain Injury Res Ctr, Dept Neurosurg, Los Angeles, CA 90095 USA
Univ Calif Los Angeles, Steve Tisch BrainSPORT Program, Los Angeles, CA 90024 USAUniv Calif Los Angeles, David Geffen Sch Med, Brain Injury Res Ctr, Dept Neurosurg, Los Angeles, CA 90095 USA
Cooke, Samantha
Greco, Tiffany
论文数: 0引用数: 0
h-index: 0
机构:
Univ Calif Los Angeles, David Geffen Sch Med, Brain Injury Res Ctr, Dept Neurosurg, Los Angeles, CA 90095 USA
Univ Calif Los Angeles, Steve Tisch BrainSPORT Program, Los Angeles, CA 90024 USAUniv Calif Los Angeles, David Geffen Sch Med, Brain Injury Res Ctr, Dept Neurosurg, Los Angeles, CA 90095 USA
Greco, Tiffany
Prins, Mayumi L.
论文数: 0引用数: 0
h-index: 0
机构:
Univ Calif Los Angeles, David Geffen Sch Med, Brain Injury Res Ctr, Dept Neurosurg, Los Angeles, CA 90095 USA
Univ Calif Los Angeles, Steve Tisch BrainSPORT Program, Los Angeles, CA 90024 USAUniv Calif Los Angeles, David Geffen Sch Med, Brain Injury Res Ctr, Dept Neurosurg, Los Angeles, CA 90095 USA