Please use this identifier to cite or link to this item:
https://dora.health.qld.gov.au/qldresearchjspui/handle/1/5024
Title: | Vomiting with head trauma and risk of traumatic brain injury | Authors: | Hearps, S. J. C. Bressan, S. Oakley, E. Kochar, A. Babl, F. E. Neutze, J. Cheek, J. A. Furyk, J. Borland, M. L. Dalziel, S. R. Phillips, N. Dalton, S. Lyttle, M. D. |
Issue Date: | 2018 | Source: | 141, (4), 2018 | Journal: | Pediatrics | Abstract: | OBJECTIVES: To determine the prevalence of traumatic brain injuries in children who vomit after head injury and identify variables from published clinical decision rules (CDRs) that predict increased risk. METHODS: Secondary analysis of the Australasian Paediatric Head Injury Rule Study. Vomiting characteristics were assessed and correlated with CDR predictors and the presence of clinically important traumatic brain injury (ciTBI) or traumatic brain injury on computed tomography (TBI-CT). Isolated vomiting was defined as vomiting without other CDR predictors. RESULTS: Of the 19 920 children enrolled, 3389 (17.0%) had any vomiting, with 2446 (72.2%) >2 years of age. In 172 patients with ciTBI, 76 had vomiting (44.2%; 95% confidence interval [CI] 36.9%-51.7%), and in 285 with TBI-CT, 123 had vomiting (43.2%; 95% CI 37.5%-49.0%). With isolated vomiting, only 1 (0.3%; 95% CI 0.0%-0.9%) had ciTBI and 2 (0.6%; 95% CI 0.0%-1.4%) had TBI-CT. Predictors of increased risk of ciTBI with vomiting by using multivariate regression were as follows: Signs of skull fracture (odds ratio [OR] 80.1; 95% CI 43.4-148.0), altered mental status (OR 2.4; 95% CI 1.0-5.5), headache (OR 2.3; 95% CI 1.3-4.1), and acting abnormally (OR 1.86; 95% CI 1.0-3.4). Additional features predicting TBI-CT were as follows: Skull fracture (OR 112.96; 95% CI 66.76-191.14), nonaccidental injury concern (OR 6.75; 95% CI 1.54-29.69), headache (OR 2.55; 95% CI 1.52-4.27), and acting abnormally (OR 1.83; 95% CI 1.10-3.06). CONCLUSIONS: TBI-CT and ciTBI are uncommon in children presenting with head injury with isolated vomiting, and a management strategy of observation without immediate computed tomography appears appropriate.L6215317422018-04-09 | DOI: | 10.1542/peds.2017-3123 | Resources: | https://www.embase.com/search/results?subaction=viewrecord&id=L621531742&from=exporthttp://dx.doi.org/10.1542/peds.2017-3123 | | Keywords: | female;head injury;headache;human;major clinical study;male;mental health;prediction;preschool child;prevalence;priority journal;clinical decision making;school child;secondary analysis;skull fracture;traumatic brain injury;vomiting;x-ray computed tomography;child;articlebehavior disorder;risk assessment;controlled study;correlation analysis | Type: | Article |
Appears in Sites: | Children's Health Queensland Publications |
Show full item record
Items in DORA are protected by copyright, with all rights reserved, unless otherwise indicated.