TY  - JOUR
PY  - 2020//
TI  - What variables correlate with different clinical outcomes of abusive head injury?
JO  - Neurosurgery
A1  - Ajmera, Sonia
A1  - Motiwala, Mustafa
A1  - Weeks, Matt
A1  - Oravec, Chesney S.
A1  - Hersh, David S.
A1  - Fraser, Brittany D.
A1  - Vaughn, Brandy
A1  - Klimo, Paul
SP  - ePub
EP  - ePub
VL  - ePub
IS  - ePub
N2  - BACKGROUND: The spectrum of injury severity for abusive head trauma (AHT) severity is broad, but outcomes are unequivocally worse than accidental trauma. There are few publications that analyze different outcomes of AHT. <br><br>OBJECTIVE: To determine variables associated with different outcomes of AHT. <br><br>METHODS: Patients were identified using our AHT database. Three different, but not mutually exclusive, outcomes of AHT were modeled: (1) death or hemispheric stroke (diffuse loss of grey-white differentiation); (2) stroke(s) of any size; and (3) need for a neurosurgical operation. Demographic and clinical variables were collected and correlations to the 3 outcomes of interest were identified using bivariate and multivariable analysis. <br><br>RESULTS: From January 2009 to December 2017, 305 children were identified through a prospectively maintained AHT database. These children were typically male (60%), African American (54%), and had public or no insurance (90%). A total of 29 children (9.5%) died or suffered a massive hemispheric stroke, 57 (18.7%) required a neurosurgical operation, and 91 (29.8%) sustained 1 or more stroke. Death or hemispheric stroke was statistically associated with the pupillary exam (odds ratio [OR] = 45.7) and admission international normalized ratio (INR) (OR = 17.3); stroke was associated with the pupillary exam (OR = 13.2), seizures (OR = 14.8), admission hematocrit (OR = 0.92), and INR (9.4), and need for surgery was associated with seizures (OR = 8.6). <br><br>CONCLUSION: We have identified several demographic and clinical variables that correlate with 3 clinically applicable outcomes of abusive head injury.<br><br>Copyright © 2020 by the Congress of Neurological Surgeons.<p />  <p>Language: en</p>
LA  - en
SN  - 0148-396X
UR  - http://dx.doi.org/10.1093/neuros/nyaa058
ID  - ref1
ER  -