%0 Journal Article
%T Glasgow Coma Scale and Outcomes after Structural Traumatic Head Injury in Early Childhood
%A Natasha L. Heather
%A Jos谷 G. B. Derraik
%A John Beca
%A Paul L. Hofman
%A Rangi Dansey
%A James Hamill
%A Wayne S. Cutfield
%J PLOS ONE
%D 2013
%I Public Library of Science (PLoS)
%R 10.1371/journal.pone.0082245
%X Objective To assess the association of the Glasgow Coma Scale (GCS) with radiological evidence of head injury (the Abbreviated Injury Scale for the head region, AIS-HR) in young children hospitalized with traumatic head injury (THI), and the predictive value of GCS and AIS-HR scores for long-term impairment. Methods Our study involved a 10-year retrospective review of a database encompassing all patients admitted to Starship Children＊s Hospital (Auckland, New Zealand, 2000每2010) with THI. Results We studied 619 children aged <5 years at the time of THI, with long-term outcome data available for 161 subjects. Both GCS and AIS-HR scores were predictive of length of intensive care unit and hospital stay (all p<0.001). GCS was correlated with AIS-HR (老=-0.46; p<0.001), although mild GCS scores (13每15) commonly under-estimated the severity of radiological injury: 42% of children with mild GCS scores had serious每critical THI (AIS-HR 3每5). Increasingly severe GCS or AIS-HR scores were both associated with a greater likelihood of long-term impairment (neurological disability, residual problems, and educational support). However, long-term impairment was also relatively common in children with mild GCS scores paired with structural THI more severe than a simple linear skull fracture. Conclusion Severe GCS scores will identify most cases of severe radiological injury in early childhood, and are good predictors of poor long-term outcome. However, young children admitted to hospital with structural THI and mild GCS scores have an appreciable risk of long-term disability, and also warrant long-term follow-up.
%U http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0082245