Evidence map›Paper›PMID 38062303›Full record

ArticleNeurocritical care2024

Multiorgan Dysfunction Syndrome in Abusive and Accidental Pediatric Traumatic Brain Injury.

Caitlin R McNamara, Katelyn M Even, Anne Kalinowski, Christopher M Horvat, Barbara A Gaines, Ward M Richardson, Dennis W Simon, Patrick M Kochanek, Rachel P Berger, Ericka L Fink

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Neurocritical care, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Observational
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Caitlin R McNamaraDepartment of Pediatric Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, USA. mcnamaracr@upmc.edu.
Katelyn M EvenDepartment of Pediatric Critical Care Medicine, Pennsylvania State University, State College, PA, USA.
Anne KalinowskiDepartment of Pediatric Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
Christopher M HorvatDepartment of Pediatric Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
Barbara A GainesDivision of Pediatric Surgery, Department of Surgery, University of Texas Southwestern, Dallas, TX, USA.
Ward M RichardsonDepartment of Pediatric Surgery, University of Pittsburgh, Pittsburgh, PA, USA.
Dennis W SimonDepartment of Pediatric Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
Patrick M KochanekDepartment of Pediatric Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
Rachel P BergerDepartment of Pediatric Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
Ericka L FinkDepartment of Pediatric Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, USA.

Funding

PEDIATRIC NEUROINTENSIVE CARE AND RESUSCITATION RESEARCHT32HD040686 · NICHD · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI Robert S B Clark, PATRICK M KOCHANEK · 2000 to 2026
$7.1M
Foundation for the National Institutes of Health 5T32HD040686-22NICHD NIH HHS T32 HD040686
6 · The paper itself

Abstract

backgroundAbusive head trauma (AHT) is a mechanism of pediatric traumatic brain injury (TBI) with high morbidity and mortality. Multiorgan dysfunction syndrome (MODS), defined as organ dysfunction in two or more organ systems, is also associated with morbidity and mortality in critically ill children. Our objective was to compare the frequency of MODS and evaluate its association with outcome between AHT and accidental TBI (aTBI).

methodsThis was a single center, retrospective cohort study including children under 3 years old admitted to the pediatric intensive care unit with nonpenetrating TBI between 2014 and 2021. Presence or absence of MODS on days 1, 3, and 7 using the Pediatric Logistic Organ Dysfunction-2 score and new impairment status (Functional Status Scale score change > 1 compared with preinjury) at hospital discharge (HD), short-term timepoint, and long-term timepoint were abstracted from the electronic health record. Multiple logistic regression was performed to examine the association between MODS and TBI mechanism with new impairment status.

resultsAmong 576 children, 215 (37%) had AHT and 361 (63%) had aTBI. More children with AHT had MODS on days 1 (34% vs. 23%, p = 0.003), 3 (28% vs. 6%, p < 0.001), and 7 (17% vs. 3%, p < 0.001) compared with those with aTBI. The most common organ failures were cardiovascular ([AHT] 66% vs. [aTBI] 66%, p = 0.997), neurologic (33% vs. 16%, p < 0.001), and respiratory (34% vs. 15%, p < 0.001). MODS was associated with new impairment in multivariable logistic regression at HD (odds ratio 19.1 [95% confidence interval 9.8-38.6, p < 0.001]), short-term discharge (7.4 [3.7-15.2, p < 0.001]), and long-term discharge (4.3 [2.0-9.4, p < 0.001])]. AHT was also associated with new impairment at HD (3.4 [1.6-7.3, p = 0.001]), short-term discharge (2.5 [1.3-4.7, p = 0.005]), and long-term discharge (2.1 [1.1-4.1, p = 0.036]).

conclusionsAbusive head trauma as a mechanism was associated with MODS following TBI. Both AHT mechanism and MODS were associated with new impairment at all time points.

Indexed as

Brain Injuries, TraumaticChild AbuseMultiple Organ FailureAccidental InjuriesChild, PreschoolFemaleHumansInfantIntensive Care Units, PediatricMaleRetrospective StudiesChild abuseLong-term effectsMultiorgan dysfunction syndromePediatric intensive care unitsTraumatic brain injury

Identifiers

PMID38062303
PMCPMC11147737

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.