Beneficio de la descompresión quirúrgica temprana en la recuperación de los pacientes pediátricos con traumatismo craneoencefálico severo en el “Hospital del Niño Dr. Francisco de Icaza Bustamante” del año 2017 a 2022.

Abstract

Introduction: Severe head trauma is one of the most frequent causes of death, as well as disability in pediatric patients. Its incidence has increased up to 50% in the last 30 years. It has been established that surgical decompression (SD) improves cerebral perfusion, reduces intracranial pressure, the tendency for midline deviation and possible herniation and compression of the brainstem. The objective of this study was to establish the benefit of early surgical decompression in the recovery of the pediatric population diagnosed with severe traumatic brain injury at the Dr. Francisco de Icaza Bustamante Children's Hospital from 2017 to 2022. Methodology: A retrospective study was carried out. observational and cross-sectional study of 270 patients who met the inclusion criteria by inspecting the medical records of the hospital system. Results: Of the 270 patients included in the study, 60.8% were male, 50% were schoolchildren, 93% underwent surgery within 24 hours. And of these, 80.7% intervened in the first 12 hours. 81.5% demonstrated Marshall type III lesion. A significant association was found between patients who underwent surgery in the first 12 hours and the shortest stay in the ICU, with an average of 4 days (p < 0.01). Conclusion: In conclusion, the study shows the benefit of performing decompressive craniotomy in the first 12 hours in patients diagnosed with severe traumatic brain injury. It is shown that, by performing it in this time window, the hospital stay and intubation time for patients is reduced, that is, there is a better prognosis.