Long Zhao, Sha Li, Yansong Liu, Zhijuan Di, Hongling Li
{"title":"意识障碍患儿接受高压氧治疗的预后危险因素分析。","authors":"Long Zhao, Sha Li, Yansong Liu, Zhijuan Di, Hongling Li","doi":"10.2147/JMDH.S517708","DOIUrl":null,"url":null,"abstract":"<p><strong>Background and objective: </strong>Disorders of consciousness (DOC) are serious neurological conditions in children, often caused by brain injury, infection, or hypoxia, with limited effective treatments. Hyperbaric oxygen therapy (HBOT) has emerged as a promising adjunctive approach due to its potential to improve cerebral oxygenation and promote neural repair. However, the prognostic factors influencing treatment outcomes in pediatric DOC remain unclear. This study aimed to identify the risk factors for prognosis of children with DOC undergoing HBOT.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 255 children diagnosed with DOC who received HBOT at the Second Hospital of Hebei Medical University from January 2010 to January 2024. Clinical data, including demographic information, etiology, Glasgow Coma Scale (GCS) scores, Coma Recovery Scale-Revised (CRS-R), treatment timing, and comorbidities, were collected. According to the Glasgow Outcome Scale (GOS) score, the children were divided into poor prognosis group and good prognosis group. Logistic regression analysis was performed to identify independent risk factors for poor prognosis.</p><p><strong>Results: </strong>Age < 12 years (OR: 0.319, 95% CI: 0.113-0.901), late timing of HBOT intervention (OR: 41.667, 95% CI: 2.122-818.296), low HBOT frequency (OR: 0.092, 95% CI: 0.019-0.441), low GCS score before HBOT (OR: 0.523, 95% CI: 0.362-0.756), low CRS-R score before HBOT (OR: 0.419, 95% CI: 0.226-0.780), and hypoxic-ischemic encephalopathy (OR: 4.885, 95% CI: 1.508-15.826) were risk factors for poor prognosis in DOC children (P < 0.05). Low GCS score before treatment was an independent risk factor for poor prognosis in DOC children after traumatic brain injury (P < 0.05), low CRS-R score before treatment was an independent risk factor for poor prognosis in DOC children after encephalitis (P < 0.05), and late timing of HBOT, low HBOT frequency and low CRS-R score before HBOT were independent risk factors for poor prognosis in DOC children after hypoxic-ischemic encephalopathy (P < 0.05).</p><p><strong>Conclusion: </strong>This study highlights the clinical value of early HBOT intervention and baseline neurological status in predicting recovery in children with DOC. Identifying these risk factors can help optimize treatment decisions and improve long-term neurological outcomes.</p>","PeriodicalId":16357,"journal":{"name":"Journal of Multidisciplinary Healthcare","volume":"18 ","pages":"3803-3812"},"PeriodicalIF":2.4000,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12227008/pdf/","citationCount":"0","resultStr":"{\"title\":\"Analysis of Prognostic Risk Factors in Children with Disorders of Consciousness Undergoing Hyperbaric Oxygen Therapy.\",\"authors\":\"Long Zhao, Sha Li, Yansong Liu, Zhijuan Di, Hongling Li\",\"doi\":\"10.2147/JMDH.S517708\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background and objective: </strong>Disorders of consciousness (DOC) are serious neurological conditions in children, often caused by brain injury, infection, or hypoxia, with limited effective treatments. Hyperbaric oxygen therapy (HBOT) has emerged as a promising adjunctive approach due to its potential to improve cerebral oxygenation and promote neural repair. However, the prognostic factors influencing treatment outcomes in pediatric DOC remain unclear. This study aimed to identify the risk factors for prognosis of children with DOC undergoing HBOT.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 255 children diagnosed with DOC who received HBOT at the Second Hospital of Hebei Medical University from January 2010 to January 2024. Clinical data, including demographic information, etiology, Glasgow Coma Scale (GCS) scores, Coma Recovery Scale-Revised (CRS-R), treatment timing, and comorbidities, were collected. According to the Glasgow Outcome Scale (GOS) score, the children were divided into poor prognosis group and good prognosis group. Logistic regression analysis was performed to identify independent risk factors for poor prognosis.</p><p><strong>Results: </strong>Age < 12 years (OR: 0.319, 95% CI: 0.113-0.901), late timing of HBOT intervention (OR: 41.667, 95% CI: 2.122-818.296), low HBOT frequency (OR: 0.092, 95% CI: 0.019-0.441), low GCS score before HBOT (OR: 0.523, 95% CI: 0.362-0.756), low CRS-R score before HBOT (OR: 0.419, 95% CI: 0.226-0.780), and hypoxic-ischemic encephalopathy (OR: 4.885, 95% CI: 1.508-15.826) were risk factors for poor prognosis in DOC children (P < 0.05). Low GCS score before treatment was an independent risk factor for poor prognosis in DOC children after traumatic brain injury (P < 0.05), low CRS-R score before treatment was an independent risk factor for poor prognosis in DOC children after encephalitis (P < 0.05), and late timing of HBOT, low HBOT frequency and low CRS-R score before HBOT were independent risk factors for poor prognosis in DOC children after hypoxic-ischemic encephalopathy (P < 0.05).</p><p><strong>Conclusion: </strong>This study highlights the clinical value of early HBOT intervention and baseline neurological status in predicting recovery in children with DOC. Identifying these risk factors can help optimize treatment decisions and improve long-term neurological outcomes.</p>\",\"PeriodicalId\":16357,\"journal\":{\"name\":\"Journal of Multidisciplinary Healthcare\",\"volume\":\"18 \",\"pages\":\"3803-3812\"},\"PeriodicalIF\":2.4000,\"publicationDate\":\"2025-06-30\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12227008/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Multidisciplinary Healthcare\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.2147/JMDH.S517708\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"HEALTH CARE SCIENCES & SERVICES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Multidisciplinary Healthcare","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2147/JMDH.S517708","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
Analysis of Prognostic Risk Factors in Children with Disorders of Consciousness Undergoing Hyperbaric Oxygen Therapy.
Background and objective: Disorders of consciousness (DOC) are serious neurological conditions in children, often caused by brain injury, infection, or hypoxia, with limited effective treatments. Hyperbaric oxygen therapy (HBOT) has emerged as a promising adjunctive approach due to its potential to improve cerebral oxygenation and promote neural repair. However, the prognostic factors influencing treatment outcomes in pediatric DOC remain unclear. This study aimed to identify the risk factors for prognosis of children with DOC undergoing HBOT.
Methods: A retrospective analysis was conducted on 255 children diagnosed with DOC who received HBOT at the Second Hospital of Hebei Medical University from January 2010 to January 2024. Clinical data, including demographic information, etiology, Glasgow Coma Scale (GCS) scores, Coma Recovery Scale-Revised (CRS-R), treatment timing, and comorbidities, were collected. According to the Glasgow Outcome Scale (GOS) score, the children were divided into poor prognosis group and good prognosis group. Logistic regression analysis was performed to identify independent risk factors for poor prognosis.
Results: Age < 12 years (OR: 0.319, 95% CI: 0.113-0.901), late timing of HBOT intervention (OR: 41.667, 95% CI: 2.122-818.296), low HBOT frequency (OR: 0.092, 95% CI: 0.019-0.441), low GCS score before HBOT (OR: 0.523, 95% CI: 0.362-0.756), low CRS-R score before HBOT (OR: 0.419, 95% CI: 0.226-0.780), and hypoxic-ischemic encephalopathy (OR: 4.885, 95% CI: 1.508-15.826) were risk factors for poor prognosis in DOC children (P < 0.05). Low GCS score before treatment was an independent risk factor for poor prognosis in DOC children after traumatic brain injury (P < 0.05), low CRS-R score before treatment was an independent risk factor for poor prognosis in DOC children after encephalitis (P < 0.05), and late timing of HBOT, low HBOT frequency and low CRS-R score before HBOT were independent risk factors for poor prognosis in DOC children after hypoxic-ischemic encephalopathy (P < 0.05).
Conclusion: This study highlights the clinical value of early HBOT intervention and baseline neurological status in predicting recovery in children with DOC. Identifying these risk factors can help optimize treatment decisions and improve long-term neurological outcomes.
期刊介绍：
The Journal of Multidisciplinary Healthcare (JMDH) aims to represent and publish research in healthcare areas delivered by practitioners of different disciplines. This includes studies and reviews conducted by multidisciplinary teams as well as research which evaluates or reports the results or conduct of such teams or healthcare processes in general. The journal covers a very wide range of areas and we welcome submissions from practitioners at all levels and from all over the world. Good healthcare is not bounded by person, place or time and the journal aims to reflect this. The JMDH is published as an open-access journal to allow this wide range of practical, patient relevant research to be immediately available to practitioners who can access and use it immediately upon publication.
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