[Severe pediatric XXXX (I). Epidemiology, clinical manifestations and course].

@entity1 @entity131 @entity101 @entity428 @entity542 @entity772
OBJECTIVE: To describe the epidemiology, clinical manifestations and evolutive characteristics of pediatric @entity1 with severe @entity542 (SHI). MATERIAL AND METHOD: A review was made of the @entity1 admitted to the pediatric intensive care unit (PICU) with SHI between July 1983 and December 2009. RESULTS: Of the 389 @entity1 with @entity542 admitted to the PICU during the study period, 174 (45%) presented SHI. The mean age in this group was of 67  9 months, with a Glasgow @entity772 Score (GCS) of 5.5  1.8 and a PRISM score of 10.7  6.7. The most frequent etiology of SHI was traffic accidents (56%), though these have decreased significantly in the last decade (58.5% vs 45.3%; P<.001). Twenty-one percent of the @entity1 required evacuation of the lesions detected by computed tomography (CT), and 39% presented severe @entity131 ( @entity131 ). Seventy-nine percent of the @entity1 in whom @entity428 ( @entity428 ) was monitored presented @entity428 . Sequelae of clinical relevance were recorded in 59 @entity1 (39%), and proved serious in 64% of the cases. The mortality rate in this @entity1 series was 24.7%. Intracranial @entity101 decreased significantly in the last decade (88% vs 54%; P<.05), and clinical recovery has improved (23.3% vs 63.1%; P<.001). CONCLUSIONS: a) The incidence of traffic accidents has decreased in the last decade in the studied population; b) @entity1 with SHI in which @entity428 was monitored showed a high incidence of @entity428 ; c) morbidity-mortality among pediatric @entity1 with SHI has decreased over the course of the study period.
