• Mabrouk Bahloul, Chokri Ben Hamida, Hedi Chelly, Adel Chaari, Hatem Kallel, Hassen Dammak, Noureddine Rekik, Kamel Bahloul, Kheireddine Ben Mahfoudh, Mongia Hachicha, and Mounir Bouaziz.
• Department of Intensive Care, Habib Bourguiba University Hospital, Sfax, Tunisia. bahloulmab@yahoo.fr
• Injury. 2009 May 1;40(5):535-40.

AimTo determine predictive factors of mortality among children after traumatic brain injury.MethodsA retrospective study over 8 years of 222 children with severe head injury (Glasgow Coma Scale score < or = 8) admitted to a university hospital (Sfax, Tunisia). Basic demographic, clinical, biological and radiological data were recorded on admission and during intensive care unit stay.ResultsThe study included 163 boys (73.4%) and 59 girls, with mean age 7.54+/-3.8 years. The main cause of trauma was road traffic accident (75.7%). Mean Glasgow Coma Scale score was 6+/-1.5, mean Injury Severity Score (ISS) was 28.2+/-6.9, mean Paediatric Trauma Score (PTS) was 3.7+/-2.1 and mean Paediatric Risk of Mortality (PRISM) was 14.3+/-8.5; 54 children (24.3%) died. Univariate analysis showed that low PTS on admission, high ISS or PRISM, presence of shock or meningeal haemorrhage or bilateral mydriasis, and serum glucose > 10 mmol l(-1) were associated with mortality rate. Multivariate analysis showed that factors associated with a poor prognosis were PRISM > 20 and bilateral mydriasis on admission.ConclusionsIn Tunisia, head injury is a frequent cause of hospital admission and is most often due to road traffic accidents. Short-term prognosis is poor, with a high mortality rate (24.3%), and is influenced by demographic, clinical, radiological and biological factors.

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