Yıl 2020, Cilt 13 , Sayı 3, Sayfalar 509 - 518 2020-09-18

Pediatrik non-travmatik koma prognozunu öngörmede klinik, elektroensefalografik ve nöroradyolojik parametrelerin rolü
The prognostic role of clinical, electroencephalographic and neuro-radiological parameters in predicting outcome in pediatric non-traumatic coma

Ayşe ANIK [1] , Hasan TEKGÜL [2] , Sanem YILMAZ [3] , Bülent KARAPINAR [4] , Ömer KİTİŞ [5] , Gül AKTAN [6] , Sarenur GÖKBEN [7]


Amaç: Pediatrik non-travmatik komada (NTK) erken dönem prognozun; klinik, elektroensefalografik ve nöroradyolojik faktörlerle ilişkisini araştırmak amaçlandı. Gereç ve Yöntem: Bu retrospektif kesitsel çalışmaya, akut ensefalopati ve NTK tanılı 77 çocuk hasta (ortalama yaş 70.5±68.7 ay, %55.8 erkek) alınmıştır. Hastaların demografik özellikleri (yaş, cinsiyet, komanın sebebi), prognozlarını belirleyen faktörler [Glasgow koma skoru (GKS)], pupil ışık refleksi, EEG ve kraniyal MR sonuçları) ve erken nörolojik sonuçları (yoğun bakım dönemi ve taburculuk sonrası ilk 3 ay) kaydedildi. Bulgular: Nontravmatik koma etiyolojisinde en sık nedenlerin hipoksik iskemik ensefalopati (HİE) ve santral sinir sistemi enfeksiyonu olduğu saptandı. İyi ve kötü nörolojik sonuçlar sırasıyla %57 ve % 43 olarak bulundu. Işık refleksinin olmaması (OR 3.09, 95% CI: 2.17 to 4.40, p<0.001), GKS ≤5 (OR 7.85, 95% CI: 2.77 to 22.37, p<0.001), EEG’de kötü prognostikpaternizlenmesi (OR 13.76, 95% CI: 1.62 to116.54, p=0.004) ve kraniyal MR’da lezyon varlığı (OR 4.04, 95% CI: 1.15 to 14.19, p=0.029) kötü prognostik bulgu olarak bulundu. Sonuç: Pediatrik NTK’da klinik, EEG ve kraniyal MR sonuçlarının kombine değerlendirilmesi hastanın nörolojik prognozunu değerlendirmede daha doğru sonuçlar verecektir.
Objective: To investigate early outcome of non-traumatic coma (NTC) in pediatric critical care in relation to prognostic role of clinical, electroencephalographic and neuro-radiological factors. Methods: A total of 77 children (mean(SD) age: 70.5±68.7 months, 55.8% were boys) with acute encephalopathy and NTC were included in this retrospective cross-sectional study. Data on patient demographics (age, gender, etiology of NTC) and four prognostic factors [Glasgow coma scores (GCS), pupillary light reflex (PLR), EEG and cranial MRI findings] and neurological outcome (ICU period and post-discharge 3rd month) were recorded in each patient. Results: Hypoxic-ischemic encephalopathy (35.1%) and CNS infection (22.1%) were the most common etiologies in the cohort. Favorable and unfavorable neurological outcome were noted in 57% and 43% of patients, respectively. Lack of PLR (OR 3.09, 95% CI: 2.17 to 4.40, p<0.001), GCS ≤5 (OR 7.85, 95% CI: 2.77 to 22.37, p<0.001), poor prognostic pattern in EEG (OR 13.76, 95% CI: 1.62 to 116.54, p=0.004) and presence of MRI lesions (OR 4.04, 95% CI: 1.15 to 14.19, p=0.029) were significant determinants of unfavorable neurological outcome. Conclusion: In conclusion, our findings emphasize that combined used of clinical, EEG and MRG patterns might provide more accurate estimation of neurological outcome in pediatric NTC.
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Birincil Dil en
Konular Pediatri
Yayınlanma Tarihi Eylül 2020
Bölüm Araştırma Makalesi
Yazarlar

Orcid: 0000-0002-0673-3403
Yazar: Ayşe ANIK (Sorumlu Yazar)
Kurum: ADNAN MENDERES UNIVERSITY
Ülke: Turkey


Orcid: 0000-0002-9972-0651
Yazar: Hasan TEKGÜL
Kurum: EGE UNIVERSITY
Ülke: Turkey


Orcid: 0000-0002-8719-0665
Yazar: Sanem YILMAZ
Kurum: EGE UNIVERSITY
Ülke: Turkey


Orcid: 0000-0002-6034-189X
Yazar: Bülent KARAPINAR
Kurum: EGE UNIVERSITY
Ülke: Turkey


Orcid: 0000-0003-4201-5449
Yazar: Ömer KİTİŞ
Kurum: EGE UNIVERSITY
Ülke: Turkey


Orcid: 0000-0002-5367-2236
Yazar: Gül AKTAN
Kurum: EGE UNIVERSITY
Ülke: Turkey


Orcid: 0000-0001-7896-5716
Yazar: Sarenur GÖKBEN
Kurum: EGE UNIVERSITY
Ülke: Turkey


Tarihler

Yayımlanma Tarihi : 18 Eylül 2020

Bibtex @araştırma makalesi { patd685215, journal = {Pamukkale Tıp Dergisi}, issn = {}, eissn = {1308-0865}, address = {Pamukkale Üniversitesi Tıp Fakültesi Eğitim Blokları Kınıklı kampüsü 20070 Kınıklı, Denizli}, publisher = {Pamukkale Üniversitesi}, year = {2020}, volume = {13}, pages = {509 - 518}, doi = {10.31362/patd.685215}, title = {The prognostic role of clinical, electroencephalographic and neuro-radiological parameters in predicting outcome in pediatric non-traumatic coma}, key = {cite}, author = {Anık, Ayşe and Tekgül, Hasan and Yılmaz, Sanem and Karapınar, Bülent and Ki̇ti̇ş, Ömer and Aktan, Gül and Gökben, Sarenur} }
APA Anık, A , Tekgül, H , Yılmaz, S , Karapınar, B , Ki̇ti̇ş, Ö , Aktan, G , Gökben, S . (2020). The prognostic role of clinical, electroencephalographic and neuro-radiological parameters in predicting outcome in pediatric non-traumatic coma . Pamukkale Tıp Dergisi , 13 (3) , 509-518 . DOI: 10.31362/patd.685215
MLA Anık, A , Tekgül, H , Yılmaz, S , Karapınar, B , Ki̇ti̇ş, Ö , Aktan, G , Gökben, S . "The prognostic role of clinical, electroencephalographic and neuro-radiological parameters in predicting outcome in pediatric non-traumatic coma" . Pamukkale Tıp Dergisi 13 (2020 ): 509-518 <https://dergipark.org.tr/tr/pub/patd/issue/55097/685215>
Chicago Anık, A , Tekgül, H , Yılmaz, S , Karapınar, B , Ki̇ti̇ş, Ö , Aktan, G , Gökben, S . "The prognostic role of clinical, electroencephalographic and neuro-radiological parameters in predicting outcome in pediatric non-traumatic coma". Pamukkale Tıp Dergisi 13 (2020 ): 509-518
RIS TY - JOUR T1 - The prognostic role of clinical, electroencephalographic and neuro-radiological parameters in predicting outcome in pediatric non-traumatic coma AU - Ayşe Anık , Hasan Tekgül , Sanem Yılmaz , Bülent Karapınar , Ömer Ki̇ti̇ş , Gül Aktan , Sarenur Gökben Y1 - 2020 PY - 2020 N1 - doi: 10.31362/patd.685215 DO - 10.31362/patd.685215 T2 - Pamukkale Tıp Dergisi JF - Journal JO - JOR SP - 509 EP - 518 VL - 13 IS - 3 SN - -1308-0865 M3 - doi: 10.31362/patd.685215 UR - https://doi.org/10.31362/patd.685215 Y2 - 2020 ER -
EndNote %0 Pamukkale Tıp Dergisi The prognostic role of clinical, electroencephalographic and neuro-radiological parameters in predicting outcome in pediatric non-traumatic coma %A Ayşe Anık , Hasan Tekgül , Sanem Yılmaz , Bülent Karapınar , Ömer Ki̇ti̇ş , Gül Aktan , Sarenur Gökben %T The prognostic role of clinical, electroencephalographic and neuro-radiological parameters in predicting outcome in pediatric non-traumatic coma %D 2020 %J Pamukkale Tıp Dergisi %P -1308-0865 %V 13 %N 3 %R doi: 10.31362/patd.685215 %U 10.31362/patd.685215
ISNAD Anık, Ayşe , Tekgül, Hasan , Yılmaz, Sanem , Karapınar, Bülent , Ki̇ti̇ş, Ömer , Aktan, Gül , Gökben, Sarenur . "The prognostic role of clinical, electroencephalographic and neuro-radiological parameters in predicting outcome in pediatric non-traumatic coma". Pamukkale Tıp Dergisi 13 / 3 (Eylül 2020): 509-518 . https://doi.org/10.31362/patd.685215
AMA Anık A , Tekgül H , Yılmaz S , Karapınar B , Ki̇ti̇ş Ö , Aktan G , Gökben S . The prognostic role of clinical, electroencephalographic and neuro-radiological parameters in predicting outcome in pediatric non-traumatic coma. Pamukkale Tıp Dergisi. 2020; 13(3): 509-518.
Vancouver Anık A , Tekgül H , Yılmaz S , Karapınar B , Ki̇ti̇ş Ö , Aktan G , Gökben S . The prognostic role of clinical, electroencephalographic and neuro-radiological parameters in predicting outcome in pediatric non-traumatic coma. Pamukkale Tıp Dergisi. 2020; 13(3): 509-518.