Factors associated with unfavorable outcomes following mild pediatric head injuries in a reference center of the north region of Minas Gerais

Abstract

Study Design: Prospective cohort. Objective: To describe clinical and demographic characteristics of a sample of children with HI referred for acute care in a referral center of the north region of Minas Gerais, Brazil, and assess clinical and radiological markers associated with unfavorable outcomes. Methodology: All children between the ages 0 to 14 years referred with head injury from February to September 2011 were included in this study. Socio-demographic and clinical data were collected at the moment of the initial assessment under informed consent. The patients were also reassessed via telephone calls after 7 and 91 days. Results: A total of 77 patients were included in this study. The mean age was 3.9 years with a standard deviation of 3.76 years. Falls and bicycle collisions were the main mechanisms of trauma. The most relevant clinical marker associated with unfavorable outcomes at 7 days was the parental perception of unusual behavior (Odds Ratio = 11.33; 95% confidence interval: 1.38-93.13; p = 0.02). Computer tomography scan abnormalities were associated with both unfavorable outcomes at 7 days (p=0.03) and at 91 days (p=0.02). Conclusions: The peculiar aspects of head injuries in a Brazilian population were described in this study. It was also found that unusual behavior and abnormalities on CT scan are factors that predict unfavorable outcomes in children with mild HI in this population.