Incidence and descriptive epidemiologic features of traumatic brain injury in King County, Washington

Area of Science:

• Pediatric emergency medicine
• Public health surveillance
• Neurotrauma epidemiology

Background:

• Traumatic brain injury (TBI) is a significant cause of childhood disability in the U.S.
• Accurate population-based incidence data for pediatric TBI is crucial for effective public health interventions.
• Understanding TBI incidence and mechanisms in children informs targeted prevention efforts.

Purpose of the Study:

• To determine the population-based incidence rates of medically treated traumatic brain injuries (TBIs) in children aged 0-17 years.
• To analyze TBI incidence by age group, gender, and mechanism of injury.
• To compare local TBI incidence rates with national estimates.

Main Methods:

• Conducted surveillance in a random sample of hospital emergency departments in King County, Washington.
• Included data from hospital admission logs and the medical examiner's office for comprehensive case identification.
• Interviewed parents and reviewed medical records for a subset of nonfatal cases to verify TBI, severity, and mechanisms.

Main Results:

• Estimated TBI incidence was 304 cases per 100,000 child-years.
• Incidence peaked in preschool-aged children and was lowest in children aged 5-9 years.
• Falls were the primary injury mechanism for preschoolers; older children experienced more injuries from being struck by objects or motor vehicle incidents. Boys had higher rates than girls, with a widening gap in older children. Approximately 97% of TBIs were mild.

Conclusions:

• Traumatic brain injuries result in numerous pediatric emergency department visits, with most cases being clinically mild.
• King County TBI incidence rates were lower than recent national estimates but consistent with prior U.S. studies.
• Tailored, age-specific prevention strategies are essential due to the variation in injury mechanisms across different age groups.