Inzidenz und Outcome nach relevantem Schädel-Hirn-Trauma

Maegele, Marc; Lefering, Rolf; Fach, H.; Engel, Doortje C.; Raum, M.; Buchheister, Bettina; Höffgen, A.; Doll, Hinnerk; Klug, N.; Weber, Friedrich; Neugebauer, Edmund; Bouillon, Bertil

doi:10.1007/s10049-008-1060-6

Cited by 5 publications

(3 citation statements)

References 27 publications

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“…Our study collective showed some special characteristics. For adult patients, the well-known higher proportion of males was found [ 14 , 15 ], whereas in younger patients, a higher percentage of females was observed. These differences in the gender distribution were in line with our observation that the trauma mechanisms differ between children and adults and might be attributable to similar leisure behaviour and the missing influence of work accidents in children.…”

Section: Discussionmentioning

confidence: 99%

Increased in-hospital mortality following severe head injury in young children: results from a nationwide trauma registry

et al. 2015

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BackgroundIn the current literature, the outcome of paediatric brain injury is controversially discussed. According to the majority of the studies, there seems to be a decreased mortality but worse recovery in paediatric, traumatic brain injury in comparison with adults. However, there is a lack of information concerning the differences in various stages of development in patients younger than 18 years. The aim of our study was to verify the in-hospital outcome of different paediatric age groups in comparison to adults with respect to the treatment strategy.MethodsWe performed a retrospective analysis of the TraumaRegister DGU® from 2002 to 2012. Inclusion criteria were an Abbreviated Injury Scale (AIS) head ≥3 points and an AIS ≤2 points of the remaining body regions. The collective was divided into different subgroups according to age (1–3, 4–6, 7–10, 11–14, 15–17) and an adult control group aged between 18 and 55 years. We descriptively analysed the endpoint rate of sepsis, multiple organ failure, and mortality. Additionally, the Glasgow Outcome Scale (GOS) at discharge was observed.ResultsOverall, 1110 children and 6491 adult control patients were included. Comparing the rate of intubation on-scene, the rate of cranial CT scans, the rate of craniotomies, and the rate and length of intensive care treatment, we could only identify minor differences between the age groups. The treatment after discharge from hospital was markedly different due to a very low rate of in-patient rehabilitation treatment in children. On one hand, the rate of systemic complications, such as sepsis and multiple organ failure increased with increasing age. On the other hand, we found a significantly increased mortality in children younger than 7 years after very (AIS head = 5) severe brain injury. The in-hospital functional outcome in survivors, according to the GOS, was beneficial for younger children in comparison to adolescents and adults.ConclusionsWe were unable to identify marked age-related differences in the therapeutic approach. Nevertheless, we were able to demonstrate marked differences of outcome. Children younger than 7 years significantly die more often due to direct impact of severe trauma. But if they survive, they seem to develop less systemic complications and profit from a better functional outcome.

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Section: Discussionmentioning

confidence: 99%

Increased in-hospital mortality following severe head injury in young children: results from a nationwide trauma registry

et al. 2015

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“…The average age of patients was 6.9 years. 4 5 6 Males were relatively higher than females in our sample size, as 51.6% of our sample size were males compared with 48.4% of females. Comparison done to identify the incidence and management of moderate to a severe head injury showed that male to female ratio is 2:1.…”

Section: Discussionmentioning

confidence: 64%

“…Comparison done to identify the incidence and management of moderate to a severe head injury showed that male to female ratio is 2:1. 5 This might be due to the type of our research, as it is a systemic review and most of our data were collected from prospective and clinical trial research. A previous study on the identification of the efficacy of metoclopramide in TBI showed that the leading causes of TBI were RTA, followed by fall.…”

Section: Discussionmentioning

confidence: 99%

Safety of Metoclopramide in Traumatic Brain Injury Patients

Jaadi

Al-Kindi

Al‐Saadi

2020

Indian Journal of Neurotrauma

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Introduction Traumatic brain injuries (TBIs) occur due to severe head assault to a hard object, with headache and vomiting being amongst the most common presenting symptoms. Metoclopramide is an old antiemetic agent that has been used widely for nausea and vomiting in TBI patients. Aim A systematic review of the literature to investigate the safety of metoclopramide in treating TBI patients. Methods A literature review was conducted in six databases, where we determined the pertinence of a study to the inclusion criteria by assessing the title, keywords, and abstracts. Five studies were found to be relevant. Data were extracted using multiple variables that were formulated incongruent with the study aim and then further analyzed. Results The collective sample size was 93 patients with an average of age 38.5 years. As much as 51.6% were male and 48.6% were females. Most patients received 10 mg metoclopramide IV with a percentage of 77.4%, while only 22.5% received 20 mg IV metoclopramide. Seventy-one patients received metoclopramide alone and 22 received combination therapy. Headache was the most common reported side effect (46.2%), followed by anxiety and drowsiness with (39.7%) and (27.9%), respectively. Fatigue was reported in 24.7%, while dystonia was the least common and developed in only 5.3% of patients. Conclusion Metoclopramide is a common medication used to treat TBI patients in the emergency department. However, the review demonstrated that the central nervous system (CNS) side effect is excepted. Treatments with lower CNS side effects may be better options.

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