Factors Associated with Intracranial Hemorrhage in Pediatric with Mild traumatic brain injury at Chiang Rai Prachanukroh Hospital
Keywords:
Mild traumatic brain injury, intracranial hemorrhage, PECARNAbstract
Background: Traumatic brain injury from accidents is one of the leading causes of death and disability in Thailand. In pediatric patients with mild traumatic brain injury, brain computed tomography (CT) scanning for diagnosing intracranial hemorrhage must consider the risks of radiation exposure and side effects from sedative medications. Knowledge of risk factors for intracranial hemorrhage leads to improved guidelines for brain CT scanning in pediatric patients with mild traumatic brain injury.
Objective: To study factors that contribute to intracranial hemorrhage in pediatric patients with mild traumatic brain injury.
Methods: This study was a retrospective cohort study of pediatric patients with mild traumatic brain injury, aged 15 years or younger, who had risk factors for intracranial hemorrhage according to the Pediatric Emergency Care Applied Research Network (PECARN) criteria and other factors, and who received brain CT scans at the Emergency Department of Chiang Rai Prachanukroh Hospital. Data were collected from October 1, 2023, to September 30, 2024, for 97 cases, Comparative analyses were collected between groups with and without intracranial hemorrhage.
Results: Of 97 patients, 14 cases had intracranial hemorrhage. Factors that significantly affected intracranial hemorrhage were suspected basilar skull fracture (RR 3.12, 95%CI 1.05-9.24, p=0.039) and Glasgow Coma Scale score (RR 5.15, 95%CI 1.18-22.51, p=0.029).
Conclusion and Recommendations: Risk factors affecting intracranial hemorrhage in pediatric patients with mild traumatic brain injury aged 15 years or younger at Chiang Rai Prachanukroh Hospital include suspected basilar skull fracture and Glasgow Coma Scale score less than 15, which showed a statistically significant association with intracranial hemorrhage (p<0.05).
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