Pediatrik non-travmatik koma prognozunu öngörmede klinik, elektroensefalografik ve nöroradyolojik parametrelerin rolü
Makaleler > Tam Makale · 2020
Yazarlar: Ayşe ANIK, Hasan TEKGÜL, Sanem KESKİN YILMAZ, Bülent KARAPINAR, Ömer KİTİŞ, GÜL AKTAN, SARENUR GÖKBEN
Pamukkale Medical Journal, Uluslararası, Scopus, 2020
DOI: 10.31362/patd.685215
Özet
Objective: To investigate early outcome of non-traumatic coma (NTC) in pediatric critical care in relation to prognostic role of clinical, electroencephalographic and neuro-radiological factors. Methods: A total of 77 children (mean(SD) age: 70.5±68.7 months, 55.8% were boys) with acute encephalopathy and NTC were included in this retrospective cross-sectional study. Data on patient demographics (age, gender, etiology of NTC) and four prognostic factors [Glasgow coma scores (GCS), pupillary light reflex (PLR), EEG and cranial MRI findings] and neurological outcome (ICU period and post-discharge 3rd month) were recorded in each patient. Results: Hypoxic-ischemic encephalopathy (35.1%) and CNS infection (22.1%) were the most common etiologies in the cohort. Favorable and unfavorable neurological outcome were noted in 57% and 43% of patients, respectively. Lack of PLR (OR 3.09, 95% CI: 2.17 to 4.40, p<0.001), GCS ≤5 (OR 7.85, 95% CI: 2.77 to 22.37, p<0.001), poor prognostic pattern in EEG (OR 13.76, 95% CI: 1.62 to 116.54, p=0.004) and presence of MRI lesions (OR 4.04, 95% CI: 1.15 to 14.19, p=0.029) were significant determinants of unfavorable neurological outcome. Conclusion: In conclusion, our findings emphasize that combined used of clinical, EEG and MRG patterns might provide more accurate estimation of neurological outcome in pediatric NTC.