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Factors associated with closed head injury in a pediatric population
P C Henry1, R P Hauber, M Rice
1Georgia State University.
Insights
Males are more prone to pediatric closed head injury (CHI), with transportation accidents and falls being leading causes. Most injuries occur in the late afternoon/evening, highlighting the need for safety interventions.
Area of Science:
- Pediatric Traumatology
- Neuroscience
- Public Health
Background:
- Pediatric closed head injury (CHI) is a significant cause of morbidity and mortality.
- Understanding the demographic and etiological factors of CHI is crucial for prevention strategies.
Purpose of the Study:
- To identify characteristic factors associated with closed head injury (CHI) in children aged 0 to 14 years.
- To analyze injury patterns, causes, severity, and outcomes in pediatric CHI cases.
Main Methods:
- Retrospective chart audit of 138 pediatric patients with CHI at a metropolitan pediatric hospital.
- Data collected included age, sex, race, injury cause, severity (Glasgow Coma Scale), season, time of accident, and hospital stay.
Main Results:
- Males were 1.5 times more likely to sustain CHI than females.
- Highest incidence in the first year of life and a secondary peak around 6 years.
- Transportation-related incidents (57.2%) and falls (22.5%) were primary causes; motor vehicle accidents comprised 27.5% of transportation injuries.
- Lack of restraint use in motor vehicle accidents was linked to 5 deaths.
- Over 70% of injuries occurred between 2:00 PM and 10:00 PM.
- Mild CHI (56.5%) was most common, but severe injuries (26.1%) and an 8% mortality rate were observed.
Conclusions:
- Pediatric CHI disproportionately affects males and is frequently linked to transportation incidents and falls.
- Peak injury times and seasonal variations suggest environmental and behavioral factors.
- Restraint use is critical in preventing fatalities in motor vehicle accidents.
- The study underscores the need for targeted prevention efforts and safety measures for children to reduce CHI incidence and severity.
Abstract:
The purpose of this study was to identify characteristic factors in children who sustained closed head injury (CHI) between birth and less than 15 years of age. A two-year retrospective audit of charts from a large metropolitan pediatric hospital with a trauma center yielded a sample of 138 charts that met the established criteria for inclusion in the study. Using a descriptive design, data were gathered on age, sex, race, cause of injury, severity of injury, season of accident, time of accident and length of hospital stay. Data analysis revealed that males were 1.5 times more likely to sustain CHI than females. Both sexes showed the highest incidence of CHI during the first year with a second less dramatic peak at around 6 years of age. Transportation-related causes accounted for 57.2% of the injuries with falls accounting for another 22.5%. Of the transportation-related injuries, 27.5% were associated with motor vehicle accidents. The lack of restraint use for subjects in the motor vehicle accident group was associated with 5 deaths as opposed to no deaths in subjects who were restrained. Over 70% of the injuries occurred in the time periods of 2:00-6:00 p.m. (31.9%) and 6:00-10:00 p.m. (40.7%). CHI occurred less frequently in the winter (13.8%) than any other season. Using the Glasgow Coma Scale scores, 56.5% of the injuries were categorized as mild, 17.4% were moderate and 26.1% were severe. There was an 8% mortality rate secondary to injury in the sample.