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Current incidence and management of children with traumatic head injuries: the Stockholm experience
Ann-Charlotte Falk1, B Klang, E J Paavonen
1Department of Women and Child Health-Neuropediatrics, Astrid Lindgren's Hospital for Children, Karolinska Institut, Stockholm, Sweden. ann-charlotte.falk@karolinska.se
Insights
Traumatic head injuries in children are common, particularly in those under 18 months. Management and documentation of pediatric head injuries are inconsistent, highlighting a need for clinical guidelines in emergency care.
Area of Science:
- Pediatric emergency medicine
- Trauma surgery
- Public health
Background:
- Traumatic head injury is a leading cause of child morbidity and mortality.
- Population-based studies on pediatric head injuries are scarce.
- Understanding incidence and management is crucial for improving outcomes.
Purpose of the Study:
- To evaluate the incidence of traumatic head injuries in children.
- To assess the management of pediatric head injuries.
- To analyze data from a level-one trauma center in Stockholm, Sweden.
Main Methods:
- Retrospective review of medical records.
- Inclusion of 3168 children presenting with head injury to the emergency department.
- Data collection over a one-year period.
Main Results:
- Overall incidence of head injury: 865 per 100,000 children.
- Highest incidence in children under 18 months (2379/10^5).
- 12% hospital admission, 13% CT scans, 0.3% neurosurgical intervention, 1% follow-up documentation.
Conclusions:
- Clinical documentation for pediatric head injuries is inconsistent.
- Lack of valid criteria impacts early management.
- Clinical guidelines are needed to improve emergency care and healthcare planning.
Purpose:
A traumatic head injury is one of the most common causes of morbidity and mortality among children, however few population-based studies in this area have been reported. Therefore, the aim of this study was to evaluate the incidence and management of traumatic head injuries in children at a level-one trauma centre in Stockholm, Sweden.
Participants:
All children (n = 3168) who visited the emergency department with a history of head injury during 1 year were included.
Method:
The required information was collected retrospectively and the children's medical records were reviewed.
Results:
The overall incidences of head injury were 865 per 100 000 children with the highest incidence (2379/10(5) children) occurring among children younger than 18 months of age. Twelve per cent (n = 396) were admitted to a hospital ward and CT scans were performed in 13% (n = 412) of all children. During this year, 0.3% required a neurosurgical intervention and only 1% of all children had documentation of a planned follow-up appointment.
Conclusion:
The findings indicate that clinical documentation as a part of the early management in children with a head injury is inconsistent and suffers from lack of valid criteria. Implementation of clinical guidelines during emergency care would help improve subsequent hospital care, as well as the planning of health care services for these children.
