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- Title
TRAUMATISMES CRANIO-ENCEPHALIQUES DE L'ENFANT DANS LE SERVICE D'ACCUEIL DES URGENCES DU CHU-GABRIEL TOURE DE BAMAKO.
- Authors
Mangané, M.; Almeimoune, A.; Diop, ThM.; Koita, S.; Dicko, H.; Sogoba, Y.; Dembélé, A. S.; Konaté, M.; Kassogué, A.; Issa, Amadou; Doumbia, Y.; Doumbia, M. Z.; Bomou, Y.; Coulibaly, Y.; Diango, D. M.
- Abstract
Objective: To study the epidemiological, clinical and evolutionary aspects of head trauma in children at the emergency room. Method: This was a descriptive longitudinal study over 1 year from February 2016 to February 2017, which included any patient aged 0 to 15 years who had cranial trauma The data were collected from a pre-established questionnaire, analyzed by the software (SPSS 22.0, EXCEL and WORD 2010).The chi-square test or Fisher's exact test was used for the statistical analysis, a value <0.5 considered significant. Results: During the study period, 19825 consultations were performed at the emergency service of which 297 cranial trauma occurred in children, ie 1.5%. The male sex was predominant at 68% with a Sex ratio (H / F) = 2.13. The 6-10 age group was the most represented with 39.4%. The students were the most represented with 58.9%. Road accidents were the predominant mechanism of injury with 54.9%. Civil protection transported 29% of the wounded. The motorcycle-pedestrian mechanism was more frequent at 27.6% (n = 82). CT was severe in 17.8% (n = 53) of patients. The photomotor reflex was abnormal in 29% (n = 86). The trauma of the lower limb was associated in 39.3%. Craniosphalic CT with cervical scan was the most performed with 73.8%. The brain lesions were in the majority with 41.1%. The average care time was 9.82h in 54.2%. Exclusive medical treatment was adopted in 91.2% of cases. The tramadol and paracetamol combination was mainly used in analgesia with 78.1% of cases The evacuation of the hematoma was the most used surgical procedure with 65.4%. Hyperthermia was the most represented ACSOS (secondary cerebral aggression of systemic origin) with 6.7%. Death before care accounted for 5.4% (n = 16), hospital death at 12.8% (n = 38). The admission time to UE was 24-48h in 31.6% (n = 168). Prognostic factors were related to Motor Photo Reflex (p = 0.002), mechanism (p = 0.01), Glasgow score <to 9 (p = 0.003), time to management (p = 0.002) and the association of ACSOS. Conclusion: CT in children remains a real public health problem responsible for considerable morbidity and mortality Pre-hospital management of ACSOS (secondary cerebral aggression of systemic origin) would significantly reduce this morbidity and mortality.
- Publication
Mali Médical, 2019, Vol 34, Issue 4, p6
- ISSN
0464-7874
- Publication type
Article