Early coagulopathy in pediatric traumatic brain injury: A Pediatric Acute and Critical Care Medicine Asian Network (PACCMAN) retrospective study

Although early coagulopathy increases mortality in adults with traumatic brain injury (TBI), less is known about pediatric TBI. OBJECTIVE: To describe the prothrombin time (PT), activated partial thromboplastin time (APTT), and platelet levels of children with moderate to severe TBI to identify pred...

Full description

Saved in:
Bibliographic Details
Main Authors: Chong, Shu-Ling, Ong, Gene Yong-Kwang, Zheng, Charles Qishi, Dang, Hongxing, Ming, Meixiu, Mahmood, Maznisah, Chan, Lawrence Chi Ngong, Chuah, Soo Lin, Lee, Olive Pei Ee, Qian, Suyun, Fan, Lijia, Konoike, Yoshihiko, Lee, Jan Hau, Asi, Pediat Acute Critical Care Med
Format: Article
Published: Oxford Univ Press Inc 2021
Subjects:
Online Access:http://eprints.um.edu.my/34499/
Tags: Add Tag
No Tags, Be the first to tag this record!
id my.um.eprints.34499
record_format eprints
spelling my.um.eprints.344992022-06-13T06:50:35Z http://eprints.um.edu.my/34499/ Early coagulopathy in pediatric traumatic brain injury: A Pediatric Acute and Critical Care Medicine Asian Network (PACCMAN) retrospective study Chong, Shu-Ling Ong, Gene Yong-Kwang Zheng, Charles Qishi Dang, Hongxing Ming, Meixiu Mahmood, Maznisah Chan, Lawrence Chi Ngong Chuah, Soo Lin Lee, Olive Pei Ee Qian, Suyun Fan, Lijia Konoike, Yoshihiko Lee, Jan Hau Asi, Pediat Acute Critical Care Med R Medicine RJ Pediatrics Although early coagulopathy increases mortality in adults with traumatic brain injury (TBI), less is known about pediatric TBI. OBJECTIVE: To describe the prothrombin time (PT), activated partial thromboplastin time (APTT), and platelet levels of children with moderate to severe TBI to identify predictors of early coagulopathy and study the association with clinical outcomes. METHODS: Using the Pediatric Acute and Critical Care Medicine Asian Network (PACCMAN) TBI retrospective cohort, we identified patients <16 yr old with a Glasgow Coma Scale (GCS) <= 13. We compared PT, APTT, platelets, and outcomes between children with isolated TBI and multiple trauma with TBI. We performed logistic regressions to identify predictors of early coagulopathy and study the association with mortality and poor functional outcomes. RESULTS: Among 370 children analyzed, 53/370 (14.3%) died and 127/370 (34.3%) had poor functional outcomes. PT was commonly deranged in both isolated TBI (53/173, 30.6%) and multiple trauma (101/197, 51.3%). Predictors for early coagulopathy were young age (adjusted odds ratio aOR] 0.94, 95% CI 0.88-0.99, P = .023), GCS < 8 (aOR 1.96, 95% CI 1.26-3.06, P = .003), and presence of multiple trauma (aOR 2.21, 95% confidence interval CI] 1.37-3.60, P = .001). After adjusting for age, gender, GCS, multiple traumas, and presence of intracranial bleed, children with early coagulopathy were more likely to die (aOR 7.56, 95% CI 3.04-23.06, P < .001) and have poor functional outcomes (aOR 2.16, 95% CI 1.26-3.76, P = .006). CONCLUSION: Early coagulopathy is common and independently associated with death and poor functional outcomes among children with TBI. Oxford Univ Press Inc 2021-08 Article PeerReviewed Chong, Shu-Ling and Ong, Gene Yong-Kwang and Zheng, Charles Qishi and Dang, Hongxing and Ming, Meixiu and Mahmood, Maznisah and Chan, Lawrence Chi Ngong and Chuah, Soo Lin and Lee, Olive Pei Ee and Qian, Suyun and Fan, Lijia and Konoike, Yoshihiko and Lee, Jan Hau and Asi, Pediat Acute Critical Care Med (2021) Early coagulopathy in pediatric traumatic brain injury: A Pediatric Acute and Critical Care Medicine Asian Network (PACCMAN) retrospective study. Neurosurgery, 89 (2). pp. 283-290. ISSN 0148-396X, DOI https://doi.org/10.1093/neuros/nyab157 <https://doi.org/10.1093/neuros/nyab157>. 10.1093/neuros/nyab157
institution Universiti Malaya
building UM Library
collection Institutional Repository
continent Asia
country Malaysia
content_provider Universiti Malaya
content_source UM Research Repository
url_provider http://eprints.um.edu.my/
topic R Medicine
RJ Pediatrics
spellingShingle R Medicine
RJ Pediatrics
Chong, Shu-Ling
Ong, Gene Yong-Kwang
Zheng, Charles Qishi
Dang, Hongxing
Ming, Meixiu
Mahmood, Maznisah
Chan, Lawrence Chi Ngong
Chuah, Soo Lin
Lee, Olive Pei Ee
Qian, Suyun
Fan, Lijia
Konoike, Yoshihiko
Lee, Jan Hau
Asi, Pediat Acute Critical Care Med
Early coagulopathy in pediatric traumatic brain injury: A Pediatric Acute and Critical Care Medicine Asian Network (PACCMAN) retrospective study
description Although early coagulopathy increases mortality in adults with traumatic brain injury (TBI), less is known about pediatric TBI. OBJECTIVE: To describe the prothrombin time (PT), activated partial thromboplastin time (APTT), and platelet levels of children with moderate to severe TBI to identify predictors of early coagulopathy and study the association with clinical outcomes. METHODS: Using the Pediatric Acute and Critical Care Medicine Asian Network (PACCMAN) TBI retrospective cohort, we identified patients <16 yr old with a Glasgow Coma Scale (GCS) <= 13. We compared PT, APTT, platelets, and outcomes between children with isolated TBI and multiple trauma with TBI. We performed logistic regressions to identify predictors of early coagulopathy and study the association with mortality and poor functional outcomes. RESULTS: Among 370 children analyzed, 53/370 (14.3%) died and 127/370 (34.3%) had poor functional outcomes. PT was commonly deranged in both isolated TBI (53/173, 30.6%) and multiple trauma (101/197, 51.3%). Predictors for early coagulopathy were young age (adjusted odds ratio aOR] 0.94, 95% CI 0.88-0.99, P = .023), GCS < 8 (aOR 1.96, 95% CI 1.26-3.06, P = .003), and presence of multiple trauma (aOR 2.21, 95% confidence interval CI] 1.37-3.60, P = .001). After adjusting for age, gender, GCS, multiple traumas, and presence of intracranial bleed, children with early coagulopathy were more likely to die (aOR 7.56, 95% CI 3.04-23.06, P < .001) and have poor functional outcomes (aOR 2.16, 95% CI 1.26-3.76, P = .006). CONCLUSION: Early coagulopathy is common and independently associated with death and poor functional outcomes among children with TBI.
format Article
author Chong, Shu-Ling
Ong, Gene Yong-Kwang
Zheng, Charles Qishi
Dang, Hongxing
Ming, Meixiu
Mahmood, Maznisah
Chan, Lawrence Chi Ngong
Chuah, Soo Lin
Lee, Olive Pei Ee
Qian, Suyun
Fan, Lijia
Konoike, Yoshihiko
Lee, Jan Hau
Asi, Pediat Acute Critical Care Med
author_facet Chong, Shu-Ling
Ong, Gene Yong-Kwang
Zheng, Charles Qishi
Dang, Hongxing
Ming, Meixiu
Mahmood, Maznisah
Chan, Lawrence Chi Ngong
Chuah, Soo Lin
Lee, Olive Pei Ee
Qian, Suyun
Fan, Lijia
Konoike, Yoshihiko
Lee, Jan Hau
Asi, Pediat Acute Critical Care Med
author_sort Chong, Shu-Ling
title Early coagulopathy in pediatric traumatic brain injury: A Pediatric Acute and Critical Care Medicine Asian Network (PACCMAN) retrospective study
title_short Early coagulopathy in pediatric traumatic brain injury: A Pediatric Acute and Critical Care Medicine Asian Network (PACCMAN) retrospective study
title_full Early coagulopathy in pediatric traumatic brain injury: A Pediatric Acute and Critical Care Medicine Asian Network (PACCMAN) retrospective study
title_fullStr Early coagulopathy in pediatric traumatic brain injury: A Pediatric Acute and Critical Care Medicine Asian Network (PACCMAN) retrospective study
title_full_unstemmed Early coagulopathy in pediatric traumatic brain injury: A Pediatric Acute and Critical Care Medicine Asian Network (PACCMAN) retrospective study
title_sort early coagulopathy in pediatric traumatic brain injury: a pediatric acute and critical care medicine asian network (paccman) retrospective study
publisher Oxford Univ Press Inc
publishDate 2021
url http://eprints.um.edu.my/34499/
_version_ 1735570306320302080
score 13.209306