Clinical Significance of Nadir Hemoglobin in Predicting Neurologic Outcome in Infants With Abused Head Trauma
Traumatic brain injury (TBI) is a leading cause of pediatric morbidity and mortality and is categorized as abusive head trauma (AHT) and accidental head injury. A retrospective chart review of 124 children aged <1 year diagnosed with TBI were analyzed. Outcomes were evaluated at discharge and...
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Frontiers Media S.A.
2020-04-01
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| Series: | Frontiers in Pediatrics |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fped.2020.00140/full |
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| author | En-Pei Lee En-Pei Lee Lu-Lu Zhao Lu-Lu Zhao Shao-Hsuan Hsia Shao-Hsuan Hsia Jung Lee Jung Lee Oi-Wa Chan Oi-Wa Chan Chia-Ying Lin Chia-Ying Lin Ya-Ting Su Ya-Ting Su Jainn-Jim Lin Jainn-Jim Lin Han-Ping Wu Han-Ping Wu Han-Ping Wu Han-Ping Wu |
| author_facet | En-Pei Lee En-Pei Lee Lu-Lu Zhao Lu-Lu Zhao Shao-Hsuan Hsia Shao-Hsuan Hsia Jung Lee Jung Lee Oi-Wa Chan Oi-Wa Chan Chia-Ying Lin Chia-Ying Lin Ya-Ting Su Ya-Ting Su Jainn-Jim Lin Jainn-Jim Lin Han-Ping Wu Han-Ping Wu Han-Ping Wu Han-Ping Wu |
| author_sort | En-Pei Lee |
| collection | DOAJ |
| description | Traumatic brain injury (TBI) is a leading cause of pediatric morbidity and mortality and is categorized as abusive head trauma (AHT) and accidental head injury. A retrospective chart review of 124 children aged <1 year diagnosed with TBI were analyzed. Outcomes were evaluated at discharge and 6 months later by using the Pediatric Cerebral Performance Category (PCPC) Scale. The receiver operating characteristic (ROC) curve was applied to determine the cutoff values for hemoglobin (HB) levels. In the study, 50 infants (40.3%) achieved a favorable neurologic outcome (PCPC ≦ 2) and 74 (59.7%) had poor neurologic outcomes (PCPC ≧ 3). Infants with poor neurologic outcomes had lower HB on admission and nadir HB (p < 0.05). Based on multivariate logistic regression analysis, the nadir HB was a predictor of poor neurologic outcomes at discharge and 6 months later in both AHT and accidental head injury. Nadir HB had the largest area under the ROC curve for predicting poor neurologic outcomes. We determined the appropriate cutoff value of nadir HB as 9.35 g/dl for predicting neurologic outcomes in infants with TBI. Furthermore, the cutoff value of nadir HB in predicting poor neurologic outcomes in infants caused by AHT and accidental head injury were taken as 9.36 and 8.75 g/dl, respectively. |
| first_indexed | 2024-12-10T23:30:44Z |
| format | Article |
| id | doaj.art-39fdc078c961428fb5bba8739bae5fd1 |
| institution | Directory Open Access Journal |
| issn | 2296-2360 |
| language | English |
| last_indexed | 2024-12-10T23:30:44Z |
| publishDate | 2020-04-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pediatrics |
| spelling | doaj.art-39fdc078c961428fb5bba8739bae5fd12022-12-22T01:29:24ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602020-04-01810.3389/fped.2020.00140493041Clinical Significance of Nadir Hemoglobin in Predicting Neurologic Outcome in Infants With Abused Head TraumaEn-Pei Lee0En-Pei Lee1Lu-Lu Zhao2Lu-Lu Zhao3Shao-Hsuan Hsia4Shao-Hsuan Hsia5Jung Lee6Jung Lee7Oi-Wa Chan8Oi-Wa Chan9Chia-Ying Lin10Chia-Ying Lin11Ya-Ting Su12Ya-Ting Su13Jainn-Jim Lin14Jainn-Jim Lin15Han-Ping Wu16Han-Ping Wu17Han-Ping Wu18Han-Ping Wu19Division of Pediatric Critical Care Medicine, Department of Pediatrics, Chang Gung Memorial Hospital at Linko, Taoyuan, TaiwanCollege of Medicine, Chang Gung University, Taoyuan, TaiwanDepartment of Pediatrics, Taipei Tzu Chi Hospital, New Taipei, TaiwanDepartment of Medicine, School of Medicine, Tzu Chi University, Hualien, TaiwanDivision of Pediatric Critical Care Medicine, Department of Pediatrics, Chang Gung Memorial Hospital at Linko, Taoyuan, TaiwanCollege of Medicine, Chang Gung University, Taoyuan, TaiwanCollege of Medicine, Chang Gung University, Taoyuan, TaiwanDivision of Pediatric General Medicine, Department of Pediatrics, Chang Gung Memorial Hospital at Linko, Taoyuan, TaiwanDivision of Pediatric Critical Care Medicine, Department of Pediatrics, Chang Gung Memorial Hospital at Linko, Taoyuan, TaiwanCollege of Medicine, Chang Gung University, Taoyuan, TaiwanDivision of Pediatric Critical Care Medicine, Department of Pediatrics, Chang Gung Memorial Hospital at Linko, Taoyuan, TaiwanCollege of Medicine, Chang Gung University, Taoyuan, TaiwanDivision of Pediatric Critical Care Medicine, Department of Pediatrics, Chang Gung Memorial Hospital at Linko, Taoyuan, TaiwanCollege of Medicine, Chang Gung University, Taoyuan, TaiwanDivision of Pediatric Critical Care Medicine, Department of Pediatrics, Chang Gung Memorial Hospital at Linko, Taoyuan, TaiwanCollege of Medicine, Chang Gung University, Taoyuan, TaiwanDivision of Pediatric General Medicine, Department of Pediatrics, Chang Gung Memorial Hospital at Linko, Taoyuan, TaiwanDepartment of Pediatric Emergency Medicine, Children's Hospital, China Medical University, Taichung, TaiwanDepartment of Medical Research, Children's Hospital, China Medical University, Taichung, TaiwanDepartment of Medicine, School of Medicine, China Medical University, Taichung, TaiwanTraumatic brain injury (TBI) is a leading cause of pediatric morbidity and mortality and is categorized as abusive head trauma (AHT) and accidental head injury. A retrospective chart review of 124 children aged <1 year diagnosed with TBI were analyzed. Outcomes were evaluated at discharge and 6 months later by using the Pediatric Cerebral Performance Category (PCPC) Scale. The receiver operating characteristic (ROC) curve was applied to determine the cutoff values for hemoglobin (HB) levels. In the study, 50 infants (40.3%) achieved a favorable neurologic outcome (PCPC ≦ 2) and 74 (59.7%) had poor neurologic outcomes (PCPC ≧ 3). Infants with poor neurologic outcomes had lower HB on admission and nadir HB (p < 0.05). Based on multivariate logistic regression analysis, the nadir HB was a predictor of poor neurologic outcomes at discharge and 6 months later in both AHT and accidental head injury. Nadir HB had the largest area under the ROC curve for predicting poor neurologic outcomes. We determined the appropriate cutoff value of nadir HB as 9.35 g/dl for predicting neurologic outcomes in infants with TBI. Furthermore, the cutoff value of nadir HB in predicting poor neurologic outcomes in infants caused by AHT and accidental head injury were taken as 9.36 and 8.75 g/dl, respectively.https://www.frontiersin.org/article/10.3389/fped.2020.00140/fullbrain injurytraumaintracranial hemorrhagenadirhemoglobininfant |
| spellingShingle | En-Pei Lee En-Pei Lee Lu-Lu Zhao Lu-Lu Zhao Shao-Hsuan Hsia Shao-Hsuan Hsia Jung Lee Jung Lee Oi-Wa Chan Oi-Wa Chan Chia-Ying Lin Chia-Ying Lin Ya-Ting Su Ya-Ting Su Jainn-Jim Lin Jainn-Jim Lin Han-Ping Wu Han-Ping Wu Han-Ping Wu Han-Ping Wu Clinical Significance of Nadir Hemoglobin in Predicting Neurologic Outcome in Infants With Abused Head Trauma Frontiers in Pediatrics brain injury trauma intracranial hemorrhage nadir hemoglobin infant |
| title | Clinical Significance of Nadir Hemoglobin in Predicting Neurologic Outcome in Infants With Abused Head Trauma |
| title_full | Clinical Significance of Nadir Hemoglobin in Predicting Neurologic Outcome in Infants With Abused Head Trauma |
| title_fullStr | Clinical Significance of Nadir Hemoglobin in Predicting Neurologic Outcome in Infants With Abused Head Trauma |
| title_full_unstemmed | Clinical Significance of Nadir Hemoglobin in Predicting Neurologic Outcome in Infants With Abused Head Trauma |
| title_short | Clinical Significance of Nadir Hemoglobin in Predicting Neurologic Outcome in Infants With Abused Head Trauma |
| title_sort | clinical significance of nadir hemoglobin in predicting neurologic outcome in infants with abused head trauma |
| topic | brain injury trauma intracranial hemorrhage nadir hemoglobin infant |
| url | https://www.frontiersin.org/article/10.3389/fped.2020.00140/full |
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