The accuracy of a clinical parameters-based scoring system to predict spontaneous intracranial hemorrhage in children under one year old
Journal Title: Paediatrica Indonesiana - Year 2015, Vol 55, Issue 3
Abstract
Background Previous studies show that most children aged less than 1 year had intracranial hemorrhage without any history of trauma. The sign and symptoms of spontaneous intracranial hemorrhage (SIH) in children varies. To minimize morbidity and mortality, early detection and accurate diagnosis are required. Head CT scans area widely used for diagnosing SIH. Unfortunately, not all health facilities in Indonesia have CT scans.Objective To determine the accuracy of a clinical parameters-based scoring system in predicting spontaneous intracranial hemorrhage (SIH) in children under one year old.Methods This diagnostic study included children aged under one year who were admitted to Mohammad Hoesin Hospital, Palembang. Patients who showed any signs of increased intracranial pressure were recruited. Data were collected from medical records from January 2007 to September 2013. Through the use of logistic regression analysis, clinical parameters showing significant relationships with computerized tomography (CT)-scan confirmed SIH were selected as predictors. Each predictor was given a score based on an adjusted ratio. The cut-off point of the total scores from all patients was determined using a receiver operating curve (ROC) analysis. The accuracy of the total scores was calculated using a 2x2 validity test.Results Of the 186 children included in this study, 98 (52.7%) had SIH and 93 (94.8%) were under 3 month-old. The predictors for SIH used included age (>3 months: score 0; 1-3 months: score 3), gender (female: score 0; male: score 1), pallor (no: score 0; yes: score 1), bulging fontanel (no: score 0; yes: score 1), pupil (isocoria: score 0; anisocoria: score 2) and history of shaken baby (no: score 0; yes: score 3). The ROC analysis showed that the area under the curve (AUC) was 95.3% with a cut-off point of 4.5, had a sensitivity of 88.7% and a specificity of 93.1%Conclusion This scoring system based on clinical parameters had good accuracy for predicting SIH in children under 1 year of age who exhibited signs of increased intracranial pressure.
Authors and Affiliations
Harris Alfan, Rita Arifin, Erial Bahar, Syarif Ansori
Keywords
Related Articles
- EP ID EP448541
- DOI 10.14238/pi55.3.2015.147-52
- Views 72
- Downloads 0
Correlation of heart failure severity and N-terminal pro-brain natriuretic peptide level in children
Background Heart failure affects morbidity and mortality in children with heart disease. There is no single, specific test to diagnose heart failure. The modified Ross Reithmann scoring system has been used to classify...
Obesity and left ventricular mass in children
Background Obesity has negative effects on cardiac function during growth leading to increased heart size and mass, as a result of higher stroke volume and cardiac output.Objective To assess for a relationship between ob...
Risk factors for neonatal mortality at Moewardi Hospital, Surakarta
Background Neonatal mortality remains a major concern indeveloping countries. Identifying potential risk factors is importantin order to decrease the neonatal mortality rate. In MoewardiHospital, Surakarta, the risk fact...
Blood pressure and lipid profiles in adolescents with hypertensive parents
Background Adolescent hypertension is a significant health problem of increasing prevalence and causes high morbidity and mortality. It is found primarily in young males, with a familial history of hypertension and/or ca...
Lactobacillus probiotics for treating functional dyspepsia in children
Background Functional dyspepsia is a common gastrointestinal disorder in school-aged children, though, there is no reliable treatment. Probiotics are live microorganisms administered in adequate amounts to confer benefic...