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Murine Model of Controlled Cortical Impact for the Induction of Traumatic Brain Injury
Published on: August 16, 2019
The epidemiology of pediatric traumatic brain injury in Minnesota
S R Reid1, J S Roesler, A M Gaichas
1Pediatric Emergency Medicine, Children's Hospitals and Clinics, 345 N Smith Ave, St Paul, MN 55102, USA. krinandsam@aol.com
Insights
Pediatric traumatic brain injury (TBI) incidence is lowest reported, but severe injuries disproportionately affect non-metropolitan children, leading to worse outcomes. This study highlights disparities in pediatric TBI care.
Area of Science:
- Pediatric Traumatology
- Epidemiology
- Public Health
Background:
- Pediatric traumatic brain injury (TBI) poses a significant public health challenge.
- Understanding the epidemiology of pediatric TBI is crucial for targeted prevention and intervention strategies.
- Disparities in TBI outcomes between urban and rural populations require investigation.
Purpose of the Study:
- To determine the epidemiology of pediatric TBI in a midwestern state.
- To examine differences in TBI incidence, outcomes, and risk factors between metropolitan and nonmetropolitan residents.
- To report the lowest incidence of pediatric TBI resulting in death or hospitalization to date.
Main Methods:
- Population-based case series design.
- Inclusion of patients aged 0-19 years sustaining TBI in 1993, resulting in hospitalization or death.
- Analysis of incidence, mortality, case-fatality rates, length of stay, discharge status, and Glasgow Outcome Scale scores.
Main Results:
- A total of 977 pediatric TBI cases were identified.
- Incidence, mortality, and case-fatality rates were 73.5, 9.3, and 12.8 per 100,000, respectively.
- Severe TBI was associated with nonmetropolitan residence, higher income, and specific injury mechanisms, with higher mortality and case-fatality rates in non-metropolitan residents.
Conclusions:
- This study reports the lowest recorded incidence of pediatric TBI leading to death or hospitalization.
- Half of severely injured pediatric patients experienced poor outcomes (disability or death).
- Non-metropolitan residents had a higher proportion of severe TBI cases and worse mortality and case-fatality rates compared to metropolitan residents.
Objectives:
To determine the epidemiology of pediatric traumatic brain injury (TBI) in a midwestern state and to examine differences between metropolitan and nonmetropolitan residents.
Design:
Population-based case series.
Participants:
Patients aged 0-19 years sustaining TBI in 1993 that resulted in hospitalization or death.
Interventions:
None.
Main Outcome Measures:
Incidence, mortality and case-fatality rates, length of hospital stay, discharge status, and Glasgow Outcome Scale score.
Results:
Nine hundred seventy-seven patients met inclusion criteria. Incidence, mortality, and case-fatality rates were 73.5 per 100 000, 9.3 per 100 000, and 12.8 per 100, respectively. Higher median household incomes and percentages of adult high-school graduates in a patient's census block group correlated with lower incidence. Median length of stay was 2 days. Of those included in the study, 720 patients (74%) were discharged home with self-care. Three hundred fifty-seven patients met criteria for severe TBI; 346 (97%) were assigned Glasgow Outcome Scale scores, of which 161 (47%) had disabilities or died. Severe TBI was associated with nonmetropolitan residence, higher median household income, and certain injury mechanisms. Incidence was similar for metropolitan and nonmetropolitan residents. Median head-region Abbreviated Injury Score, Injury Severity Score, and mortality and case-fatality rates were higher for nonmetropolitan residents.
Conclusions:
This study reports the lowest incidence of pediatric TBI that results in death or hospitalization to date. One half of severely injured patients suffered poor outcomes. A greater proportion of nonmetropolitan than metropolitan residents suffered severe TBI and had higher mortality and case-fatality rates.
