UNASSIGNED: OBJECT The goal of critical care in treating @entity131 ( @entity131 ) is to reduce secondary @entity1545 by limiting @entity2806 and optimizing cerebral blood flow. The authors compared short-term outcomes as defined by discharge disposition and Glasgow Outcome Scale scores in @entity1 with @entity131 before and after the implementation of a protocol that standardized decision-making and interventions among neurosurgeons and pediatric intensivists. METHODS The authors performed a retrospective pre- and postprotocol study of 128 pediatric @entity1 with severe @entity131 , as defined by Glasgow @entity772 Scale (GCS) scores < 8, admitted to a tertiary care center pediatric critical care unit between April 1, 2008, and May 31, 2014. The preprotocol group included 99 @entity1 , and the postprotocol group included 29 @entity1 . The primary outcome of interest was discharge disposition before and after protocol implementation, which took place on April 1, 2013. Ordered logistic regression was used to assess outcomes while accounting for @entity130 and clinical parameters. Favorable discharge disposition included discharge home. Unfavorable discharge disposition included discharge to an inpatient facility or @entity204 . RESULTS Demographics were similar between the treatment periods, as was @entity130 as assessed by GCS score (mean 5.43 preprotocol, mean 5.28 postprotocol; p = 0.67). The ordered logistic regression model demonstrated an odds ratio of 4.0 of increasingly favorable outcome in the postprotocol cohort (p = 0.007). Prior to protocol implementation, 63 @entity1 (64%) had unfavorable discharge disposition and 36 @entity1 (36%) had favorable discharge disposition. After protocol implementation, 9 @entity1 (31%) had unfavorable disposition, while 20 @entity1 (69%) had favorable disposition (p = 0.002). In the preprotocol group, 31 @entity1 (31%) died while 6 @entity1 (21%) died after protocol implementation (p = 0.04). CONCLUSIONS Discharge disposition and mortality rates in pediatric @entity1 with severe @entity131 improved after implementation of a standardized protocol among caregivers based on best-practice guidelines.

Standardizing ICU management of pediatric XXXX is associated with improved outcomes at discharge.

@entity1545 :: ('MESH:D020214', 'Disease') :: ['brain injury'] @entity1 :: ('9606', 'Species') :: ['children', 'patients'] @entity131 :: ('MESH:D001930', 'Disease') :: ['TBI', 'traumatic brain injury'] @entity2806 :: ('MESH:D002545', 'Disease') :: ['cerebral ischemia'] @entity772 :: ('MESH:D003128', 'Disease') :: ['Coma'] @entity204 :: ('MESH:D003643', 'Disease') :: ['death'] @entity130 :: ('MESH:D014947', 'Disease') :: ['injury severity']
@entity131 :: (MESH:D001930,Disease) :: ['traumatic brain injury']
