Ability of the PILOT Score to Predict 6-Month Functional Outcome in Pediatric Patients with Moderate-Severe Traumatic Brain Injury

Details

• Journal Article:
  J Pediatr Surg
• Personal Author:
  Flaherty, Brian F. ; Jackson, Margaret L. ; Cox, Charles S. ; Clark, Amy ; Ewing-Cobbs, Linda ; Holubkov, Richard ; Moore, Kevin R. ; Patel, Rajan P. ; Keenan, Heather T.
• Description:
  Purpose: ; To assess the Pediatric Intensity Level of Therapy (PILOT) score alone and in combination with Emergency Department (ED) GCS and Rotterdam score of initial head CT to predict functional outcomes in children with traumatic brain injury (TBI). ; Methods: ; Children (n=108) aged 31 months-15 years with moderate to severe TBI were prospectively enrolled at two sites. The ability of PILOT, ED GCS, and Rotterdam scores to predict the 6-month Pediatric Injury Functional Outcome Scale (PIFOS) was evaluated using multivariable regression models with enrollment site, age, and sex as covariates. ; Results: ; PILOT total (sum) score was more predictive of PIFOS (R2 = 0.23) compared to mean (R2 = 0.20) or peak daily PILOT scores (R2 = 0.11). PILOT total score predicted PIFOS better than ED GCS (R2 = 0.01) or Rotterdam score (R2 = 0.06) and was similar to PILOT, ED GCS, and Rotterdam score combined. PILOT total score performed better in patients with intracranial pressure monitors (n=30, R2 = 0.28, slope = 0.30) than without (n=78, R2 = 0.09, slope = 0.36). ; Conclusions: ; The PILOT score correlated moderately with functional outcome following TBI and outperformed other common predictors. PILOT may be a useful predictor or moderator of functional outcomes.
• Keywords:
  • Pediatrics
  • Traumatic Brain Injury
  • Prognosis
  • Intracranial Pressure
  • Adolescent
  • Brain Injuries, Traumatic
  • Child
  • Clinical Decision Rules
  • Female
  • Glasgow Coma Scale
  More +
• Source:
  J Pediatr Surg. 55(7):1238-1244
• DOI:
  http://dx.doi.org/10.1016/j.jpedsurg.2019.06.022
• Pubmed ID:
  31327541
• Pubmed Central ID:
  PMC6946892
• Document Type:
  Text ; Journal Article
• Funding:
  K24 HD072984/HD/NICHD NIH HHSUnited States/ ; T32 GM008792/GM/NIGMS NIH HHSUnited States/ ; U01 CE002188/CE/NCIPC CDC HHSUnited States/ ; U01CE002188/ACL/ACL HHSUnited States/
• Genre:
  Journal Article
• Volume:
  55
• Issue:
  7
• Download URL:
  https://stacks.cdc.gov/view/cdc/84064/cdc_84064_DS1.pdf
• File Type:
  [PDF - 585.46 KB]
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:455e167bbb3ed918af531a416af3956c3ee87a32cf87e5b508a43df0b963c8a9db96fb939cbd726bb5e75740ae6fd955434f966c3c97d33bc7e79f4b1ea69e47