Risk of traumatic intracranial haemorrhage in children with bleeding disorders.
bleeding disorder
children
head trauma
intracranial haemorrhage
Journal
Journal of paediatrics and child health
ISSN: 1440-1754
Titre abrégé: J Paediatr Child Health
Pays: Australia
ID NLM: 9005421
Informations de publication
Date de publication:
Dec 2020
Dec 2020
Historique:
received:
08
05
2019
revised:
14
06
2020
accepted:
16
06
2020
pubmed:
19
8
2020
medline:
15
5
2021
entrez:
19
8
2020
Statut:
ppublish
Résumé
To assess computerised tomography (CT) use and the risk of intracranial haemorrhage (ICH) in children with bleeding disorders following a head trauma. Design: Multicentre prospective observational study. 10 paediatric emergency departments (ED) in Australia and New Zealand. Children <18 years with and without bleeding disorders assessed in ED following head trauma between April 2011 and November 2014. Data collection of patient characteristics, management and outcomes. Rate of CT use and frequency of ICH on CT. Of 20 137 patients overall, 103 (0.5%) had a congenital or acquired bleeding disorder. CT use was higher in these patients compared with children without bleeding disorders (30.1 vs. 10.4%; rate ratio 2.91 95% CI 2.16-3.91). Only one of 31 (3.2%) children who underwent CT in the ED had an ICH. This patient rapidly deteriorated in the ED on arrival and required neurosurgery. None of the patients with bleeding disorders who did not have a CT obtained in the ED or had an initial negative CT had evidence of ICH on follow up. Although children with a bleeding disorder and a head trauma more often received a CT scan in the ED, their risk of ICH seemed low and appeared associated with post-traumatic clinical findings. Selective CT use combined with observation may be cautiously considered in these children based on clinical presentation and severity of bleeding disorder.
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
1891-1897Subventions
Organisme : A + Trust (Auckland District Health Board)
Organisme : Auckland Medical Research Foundation
ID : 3112011
Organisme : Centre of Research Excellence for Paediatric Emergency Medicine
ID : GNT1058560
Organisme : Emergency Medicine Foundation
ID : EMPJ-11162
Organisme : Health Research Council of New Zealand
ID : HRC13/556
Organisme : National Health and Medical Research Council
ID : GNT1046727
Organisme : NHMRC Practitioner Fellowship
Organisme : Perpetual Philanthropic Services
ID : 2012/1140
Organisme : Townsville Hospital and Health Service Private Practice Research and Education Trust Fund
Organisme : WA Health Targeted Research Funds 2013
Organisme : Royal Children's Hospital Foundation and the Melbourne Campus Clinician Scientist Fellowship
Organisme : Victorian Government's Infrastructure Support Program
Organisme : Murdoch Children's Research Institute
Informations de copyright
© 2020 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).
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