Blood pressure and outcome after severe pediatric traumatic brain injury

Background. The relationship between systolic blood pressure and outcome in children after severe traumatic brain injury (TBI) is unclear. We examined the relationship between age-appropriate systolic blood pressure (AASBP) percentile and outcome after severe pediatric TBI. Methods. We examined the association between AASBP percentiles and outcome in 172 children younger than 14 years of age with a Glasgow Coma Scale score < 9. Outcome was evaluated using discharge Glasgow Outcome Scale score. Poor outcome was defined as a Glasgow Outcome Scale score < 4. Results. Poor outcome was associated with AASBP < 75th percentile (odds ratio, 4.2; 95% confidence interval, 2.1-8.3). Patients with systolic blood pressure (SBP) ! 90 turn Hg and AASBP < 75th percentile had a higher odds for poor outcome compared with patients with SBP greater than or equal to 90 mm Hg and AASBP greater than or equal to 75th percentile (odds ratio, 3.5; 95% confidence interval, 1.7-7.3). Conclusion. AASBP < 75th percentile was associated with poor outcome after severe pediatric TBI, even when SBP was greater than or equal to 90 min Hg.