BACKGROUND: Basal skull fractures (BSFs) are caused by blunt force @entity130 , occurring in the temporal, occipital, sphenoid, and/or ethmoid bones. In pediatric severe traumatic @entity1545 (sTBI), there is a paucity of data on BSFs. Our goal was to investigate the BSF prevalence, anatomy, and association with short-term outcomes in pediatric sTBI. METHODS: We retrospectively reviewed all severely injured (Injury Severity Score >= 12) pediatric @entity1 (aged <18 years) admitted to our hospital after experiencing an sTBI (Glasgow @entity772 Scale score  <=8 and head Abbreviated Injury Scale score >= 4). Neuroimaging for all sTBI @entity1 was reviewed for skull fractures. Data were analyzed with both univariate and multivariate techniques. RESULTS: Of the 180 @entity1 with sTBI, 47 had BSFs for a prevalence of 26% (69 BSFs in total; 16 sTBI @entity1 had >= 2 BSFs). The squamous temporal bone was fractured most frequently (n=30/47 sTBI @entity1 with BSFs). @entity1 with BSFs were heavier and had more @entity8494 than those without (p < 0.05) but were similar in all other admission demographics, injury profiles, and clinical characteristics. @entity5173 was found in 32% (n = 15 of 47) of BSF @entity1 ( @entity2972 , n = 12; @entity5254 , n = 1; @entity2972 / @entity5254 , n = 2; p < 0.001). Mortality, @entity6659 , and fewer ventilator-free days were associated with BSFs (p < 0.005), whereas in sTBI survivors, BSFs were associated with longer lengths of stay (p < 0.05). Multiple logistic regression showed that BSFs were positively associated with the presence of @entity510 (odds ratio [OR], 4.00; p = 0.001), contusion (OR, 2.48; p = 0.029), herniation (OR, 3.40; p = 0.037), and @entity2657 (OR, 2.30; p = 0.047) but negatively associated with @entity21 (OR, 0.20; p = 0.003). BSFs and mortality were strongly associated (OR, 6.87; p = 0.019). CONCLUSION: BSFs occurred in 26% of pediatric sTBI @entity1 . The temporal bone was fractured in two thirds of sTBI @entity1 with BSFs, and one third was associated with @entity5173 . BSFs represent a significant linear blunt force and are independent predictors of mortality. LEVEL OF EVIDENCE: Prognostic and epidemiologic study, level III.

Basal skull fractures are associated with mortality in pediatric severe traumatic XXXX .

@entity1545 :: ('MESH:D020214', 'Disease') :: ['brain injury'] @entity1 :: ('9606', 'Species') :: ['Patients', 'patients'] @entity2657 :: ('MESH:D001929', 'Disease') :: ['cerebral edema'] @entity510 :: ('MESH:D013345', 'Disease') :: ['subarachnoid hemorrhage'] @entity2972 :: ('MESH:D002558', 'Disease') :: ['otorrhea'] @entity772 :: ('MESH:D003128', 'Disease') :: ['Coma'] @entity5173 :: ('MESH:D065634', 'Disease') :: ['cerebrospinal fluid leaks', 'Cerebrospinal fluid leak'] @entity5254 :: ('MESH:D002559', 'Disease') :: ['rhinorrhea'] @entity8494 :: ('MESH:D005151', 'Disease') :: ['facial injuries'] @entity21 :: ('MESH:D001480', 'Disease') :: ['diffuse axonal injury'] @entity6659 :: ('MESH:D020790', 'Disease') :: ['acute central diabetes insipidus'] @entity130 :: ('MESH:D014947', 'Disease') :: ['trauma']
@entity1545 :: (MESH:D020214,Disease) :: ['brain injury']
