Increased risk of death associated with hypotension is not altered by the presence of brain injury in pediatric trauma patients

Gunst, Mark A.; Sperry, Jason L.; Ghaemmaghami, Vafa; Gunst, Richard F.; Friese, Randall S.; Frankel, Heidi L.; Gentilello, Larry M.; Shafi, Shahid

doi:10.1016/j.amjsurg.2007.08.026

« Previous Next »The American Journal of Surgery
Volume 194, Issue 6 , Pages 741-745, December 2007

Increased risk of death associated with hypotension is not altered by the presence of brain injury in pediatric trauma patients

Presented at the 59th Annual Meeting of the Southwestern Surgical Congress, Rancho Mirage, CA, March 25–29, 2007

Division of Burns, Trauma and Surgical Critical Care, Department of Surgery, University of Texas Southwestern Medical School, 5323 Harry Hines Blvd, Dallas, TX 75390-9158, USA

Received 21 April 2007; received in revised form 14 August 2007

Abstract

Background

Hypotension is a well-known predictor of mortality in pediatric trauma patients. However, it is unknown whether the mortality rate is higher in patients with traumatic brain injury (TBI) than in those without TBI. We hypothesized that systemic hypotension increases mortality in pediatric patients with TBI more than it does in pediatric patients with extracranial injuries only.

Methods

Multivariate logistic regression was used to determine the relationship between hypotension and the risk of death. Patients were then divided into 2 groups: TBI and No-TBI and the model was applied separately to each group.

Results

Overall mortality was 2%. After adjusting for confounding variables, hypotension remained a strong independent predictor of mortality. However, the increased risk of death was similar in patients with and without TBI.

Conclusion

Hypotension is an important predictor of death in pediatric trauma patients. The increased risk of death associated with hypotension is similar with or without traumatic brain injury.

Keywords: Pediatric, Traumatic brain injury, Hypotension, Mortality