Predictors of Outcome in Pediatric Head Injury at a Teaching Hospital, Chitwan

Head injury a significant cause of morbidity and mortality in children worldwide. The outlook of head injury still continues to be a major challenge in our part of the world. This study explored the predictors of outcome in pediatric head injury.All the patients from 1 day to 18 years admitted with head injury in different departments of Chitwan Medical College over the period of 5 years (2016/1/1 to 2020/12/31) were studied retrospectively. Data were collected from patient?s record using semi-structured data collection performa and analyzed using descriptive and inferential statistics. The outcome of all these patients was assessed by Glasgow outcome scale and divided into favorable (normal, moderate disability) and unfavorable (severe, vegetative, dead) outcome. Outcome was assessed in relation to age, sex, mode of injury, diagnosis, surgical intervention, associated injury and GCS at admission. A total of 419 patients were included in the study comprising 69.2% males and 30.8% females, 36.8% were from age group 1-5 years (mean age 8.56 years S.D. 5.41). The common modes of injury were road traffic accidents (52.7%) followed by fall (43.4%). Highest number of patients had skull fracture (28.9%), followed by EDH (22.2%). Surgical interventions were required in 24.3% and 16.5% had other associated injuries. Majority of patients had mild head injury (63.5%), followed by moderate head injury (25.1%) and severe head injury (11.5%). Favorable outcome was seen in 95.2% while 4.8% had unfavorable outcome with mortality rate of 3.6%.Association between outcomes of head injury with diagnosis and severity of head injury were statistically significant (pless than0.05). Outcome was greatly influenced by GCS at admission, as ratio of unfavorable outcome was greater with severe head injury.