TY  - JOUR
PY  - 2013//
TI  - Base deficit correlates with mortality in pediatric abusive head trauma
JO  - Journal of pediatric surgery
A1  - Stewart, Camille L.
A1  - Holscher, Courtenay M.
A1  - Moore, Ernest E.
A1  - Bronsert, Micheal
A1  - Moulton, Steven L.
A1  - Partrick, David A.
A1  - Bensard, Denis D.
SP  - 2106
EP  - 2111
VL  - 48
IS  - 10
N2  - 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>
LA  - en
SN  - 0022-3468
UR  - http://dx.doi.org/10.1016/j.jpedsurg.2013.05.009
ID  - ref1
ER  -