Preschool Children with Head Injury: Comparing Injury Severity Measures And Clinical Care

Youngblut, JoAnne M.; Caicedo, Carmen; Brooten, Dorothy
November 2013
Pediatric Nursing;Nov/Dec2013, Vol. 39 Issue 6, p290
Academic Journal
The purpose of this study was to compare child, hospital course, and discharge characteristics by admitting unit, injury type, head Abbreviated Injury Scale (AIS), and Glasgow Coma Scale (GCS), and test congruence of AIS and GCS categories. Chart data were collected from seven hospitals on 183 preschool children with head injury (90 admitted to PICU, 93 to general care unit). Injury events included falls (n = 89, 49%), hit by car (n = 35, 19%), motor vehicle crashes (n = 26, 14%), bicycle crashes (n = 12, 7%), and blunt traumas (n = 21, 11%). Most children (68%) had head injuries only, 20% had other fractures, 5% had organ damage, and 7% had all three. Injury severity was measured by head AIS and GCS scores. Treatments and procedures included tubes/lines, blood/blood products, and medications. Children with head injuries only had fewer hospital days, less severe head injuries, and near normal GCS scores. They were less likely to have tubes/lines and medications. Children were discharged with medications (61%) and medical equipment (14%). Five children were discharged to long-term care facilities, and five were discharged to rehabilitation facilities. Concordance of head AIS and GCS categories occurred for only 50 (28%) children. Although the GCS is the gold standard for identifying changes in neurological status, it was not as helpful in representing hospital care. Head AIS injury categories clustered children in more homogeneous groups and better represented hospital care. Head AIS categories are better indicators of injury severity and care provided than GCS. Head injury AIS score may be an important addition to GCS for guiding care.


Related Articles

  • Clinical Scoring Systems in Predicting Health--Related Quality of Life of Children with Injuries. Meštrović, Julije; Meštrović, Marija; Polić, Branka; Markić, Josko; Kardum, Goran; Gunjaca, Grgo; Matas, Anita; Catipović, Tatjana; Radonić, Marija // Collegium Antropologicum;Jun2013, Vol. 37 Issue 2, p373 

    The aim of the study was to explore the association between Glasgow Coma Scale (GCS), Paediatric Index of Mortality (PIM2) and Injury Severity Score (ISS), and the long-term outcome of children with injuries. The health related quality of life (HRQL) was assessed by using the Royal Alexandra...

  • Do Facial Fracture Protect the Brain or Are They a Marker for Severe Head Injury? Martin II, Robert C.G.; Spain, David A.; Richardson, J. David // American Surgeon;May2002, Vol. 68 Issue 5, p477 

    Facial fractures (FF) have been suggested to protect the brain from severe injury. However, others have stated that facial fractures are a marker for increased risk of brain injury. The aim of this study is to evaluate the association between facial fractures, brain injury, and functional...

  • Emergency care of children and adults with head injury. Bethel, James // Nursing Standard;6/27/2012, Vol. 26 Issue 43, p49 

    Head injury is common and accounts for a significant proportion of patient attendances at emergency departments and minor injury units. While most injuries will not be serious in nature, some will be severe. Therefore assessment, investigation and early management of head injury are essential to...

  • A prospective observational study to assess the diagnostic accuracy of clinical decision rules for children presenting to emergency departments after head injuries (protocol): the Australasian Paediatric Head Injury Rules Study (APHIRST). Babl, Franz E.; Lyttle, Mark D.; Bressan, Silvia; Borland, Meredith; Phillips, Natalie; Kochar, Amit; Dalziel, Stuart R.; Dalton, Sarah; Cheek, John; Furyk, Jeremy; Gilhotra, Yuri; Neutze, Jocelyn; Ward, Brenton; Donath, Susan; Jachno, Kim; Crowe, Louise; Williams, Amanda; Oakley, Ed // BMC Pediatrics;2014, Vol. 14 Issue 1, p1 

    Background Head injuries in children are responsible for a large number of emergency department visits. Failure to identify a clinically significant intracranial injury in a timely fashion may result in long term neurodisability and death. Whilst cranial computed tomography (CT) provides rapid...

  • Epidemiology and treatment outcome of head injury in children: A prospective study. Nnadi, M. O. N.; Bankole, O. B.; Fente, B. G. // Journal of Pediatric Neurosciences;Sep-Dec2014, Vol. 9 Issue 3, p237 

    Head injury in children is a major concern all over the world. The increasing level of poverty in the world is exposing more children to trauma situations. The future consequences of trauma in these children are enormous, hence prevention they say, is better than cure. Aim of the Study: The...


    A study is reported of children with head injuries (slight and severe) as compared with matched control groups. Findings are reported and discussed.

  • Correlation between neurotrophic factor expression and outcome of children with severe traumatic brain injury. Chiaretti, Antonio; Piastra, Marco; Polidori, Giancarlo; Di Rocco, Concezio; Caresta, Elena; Antonelli, Alessia; Amendola, Tiziana; Aloe, Luigi // Intensive Care Medicine;Aug2003, Vol. 29 Issue 8, p1329 

    Objectives: We evaluated the neurotrophic factors [nerve growth factor (NGF), brain-derived neurotrophic factor (BDNF), glia-derived neurotrophic factor (GDNF)] expression and their association with the severity and outcome of children with traumatic brain injury.Design:...

  • Pediatric Polytrauma Management. Jakob, Heike; Lustenberger, Thomas; Schneidmüller, Dorien; Sander, Anna; Walcher, Felix; Marzi, Ingo // European Journal of Trauma & Emergency Surgery;Aug2010, Vol. 36 Issue 4, p325 

    Caring for pediatric trauma patients requires an understanding of the distinct anatomy and pathophysiology of the pediatric population compared to adult trauma patients. Initial evaluation, management, and resuscitation are performed as a multidisciplinary approach including pediatric...

  • Severe brain injury: Helping patient and family on the long road back. Blackman, James A. // Contemporary Pediatrics;Jan2005, Vol. 22 Issue 1, p63 

    The article discusses the medical, emotional-behavioral, social and financial ramifications of severe traumatic brain injury (TBI) and the interventions that are likely to improve outcome. Primary care physicians have an important role in the prevention and the aftermath of TBI. Motor vehicle...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics