The Effect Of Admission Anemia On The Prognosis In Pediatric Patients With Moderate To Severe Traumatic Brain Injury

Objective: To explore the effect of admission anemia on the prognosis in children with moderate to severe traumatic brain injury(TBI).Methods: This retrospective cohort study was conducted in Department of Critical Care Medicine,Children's Hospital of Chongqing Medical University between May 2012 and October 2014 included patients with moderate to severe traumatic brain injury [Glasgow Coma Scale(GCS)3~13].The patients were divided into non-anemia group(Hb?100g/L)and anemia group(Hb<100g/L)according to admission hemoglobin level.Non parametric test and chi square test was used to explore the differences between the groups.Multivariate Logistic analysis was used to analyze the independent risk factors of death in children.Result: Totally 109 patients were enrolled and 17 patients among them died in hospital.The admission hemoglobin of 52 patients were less than100g/L.Compared with those of patients without admission anemia,the ages were younger,weight were lighter,GCS and PTS were lower in admission anemia patients(P<0.05).Univariate analysis found thatadmission anemia,hyperglycemia,GCS < 8,pediatric trauma score(PTS)<8,abnormal pupil reflex ratio and polytrauma significantly influenced mortality(all P< 0.05).Multivariate Logistic regression analysis showed that admission anemia(AOR=9.383;95% CI=1.086 to 81.094;P =0.042),abnormal pupil reflex(AOR=23.121;95% CI 3.680 to 145.270;P =0.001)and admission hyperglycemia(AOR=15.181;95% CI=2.019-114.160;P=0.008)were independent risk factors for death in children with moderate or severe TBI.Conclusion: The admission anemia is an independent risk factor for the mortality of pediatric patients with moderate to severe TBI.And admission anemia is associated with death in patients.