@article{ref1,
title="Base deficit correlates with mortality in pediatric abusive head trauma",
journal="Journal of pediatric surgery",
year="2013",
author="Stewart, Camille L. and Holscher, Courtenay M. and Moore, Ernest E. and Bronsert, Micheal and Moulton, Steven L. and Partrick, David A. and Bensard, Denis D.",
volume="48",
number="10",
pages="2106-2111",
abstract="BACKGROUND/PURPOSE: Children suffering from abusive head trauma (AHT) have worse outcomes compared to non-AHT, but the reasons for this are unclear. We hypothesized that delayed medical care associated with AHT causes prolonged pre-hospital hypotension and hypoxia as measured by admission base deficit (BD), and that this would correlate with outcome.   METHODS: We performed a 10-year retrospective chart review of children admitted for AHT at two academic level-I trauma centers. Statistics were performed using Student's t test, chi-square analysis, and multivariate logistic regression, and considered significant at p<0.05.   RESULTS: Four-hundred twelve children with AHT were identified, and admission BD was drawn for 148/412 (36%) children, including 104 survivors and 44 non-survivors. Non-survivors had significantly higher BD compared to survivors (12.6±1.6 versus 5.3±0.6, p<0.001). Non-survivors were more likely to be intubated pre-hospital and get cardiopulmonary resuscitation (CPR) (p<0.001). Mortality increased with rising BD, according to CPR status. There was no difference in patterns of brain injury between survivors and non-survivors (p>0.05).   CONCLUSIONS: BD correlates with mortality in children suffering severe AHT. Non-survivors are also more likely to be intubated pre-hospital and require CPR, with no difference in pattern of brain injury, suggesting that secondary injury is a major determinant of outcome in severe AHT.<p /> <p>Language: en</p>",
language="en",
issn="0022-3468",
doi="10.1016/j.jpedsurg.2013.05.009",
url="http://dx.doi.org/10.1016/j.jpedsurg.2013.05.009"
}