24: Subarachnoid Hemorrhage is not Independently Associated with Mortality in Pediatric Severe Traumatic Brain Injury
Bibliographic record
Abstract
Subarachnoid hemorrhage (SAH) is an independent prognostic indicator of outcome in adult patients who have suffered a severe traumatic brain injury (sTBI). There is a paucity of investigations on SAH in pediatric sTBI. The goal of this study was to determine SAH incidence, associated factors and its relationship to outcome in pediatric sTBI patients. Included were 171 sTBI patients (pre-sedation GCS ≤8 and head MAIS ≥4) who underwent CT head imaging within the first 24 h of hospital admission We found that 42% of sTBI patients had SAH (n=71 of 171), and that SAH was more frequently associated with cerebral edema, diffuse axonal injury, contusion and intraventricular hemorrhage (P<0.05). Patients with SAH had higher injury severity scores (P=0.032) and a greater frequency of fixed pupil(s) on admission (P=0.001). There were no significant differences in etiologies between sTBI patients with and without SAH. Worse disposition occurred in sTBI patients with SAH, including increased mortality (P=0.009), increased episodes of central diabetes insipidus (P=0.002), greater infection rates (P=0.002) and fewer ventilator-free days (P=0.001). In sTBI survivors, SAH was associated with increased lengths of stay (P<0.001) and a higher level of care required on discharge (P=0.004). Despite a strong relationship between SAH and sTBI outcome on univariate analysis, multivariate analysis failed to demonstrate that SAH had an independent association with mortality (P=0.969). In conclusion, SAH was a frequent head imaging abnormality in almost half of pediatric sTBI patients and it appeared to be indicative of more severe TBI. As opposed to adult sTBI, SAH in pediatric patients was not independently associated with increased risk of mortality.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".