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Pediatric Traumatic Brain Injury: a 5-year descriptive study from the National Trauma Center in Qatar
Ayman El-Menyar1,2, Rafael Consunji3, Hassan Al-Thani4
1Clinical Research, Trauma Surgery Section, Hamad General Hospital, Doha, Qatar.
Insights
Pediatric traumatic brain injury (pTBI) is under-documented in the Arab Middle East. Teenagers aged 15-18 years experienced the highest rates, severity, and mortality from pTBI, primarily due to motor vehicle crashes.
Area of Science:
- Neuroscience
- Public Health
- Epidemiology
Background:
- Limited data exists on pediatric traumatic brain injury (pTBI) in the Arab Middle East.
- Understanding pTBI epidemiology is crucial for developing targeted interventions.
Purpose of the Study:
- To describe the epidemiologic characteristics, injury mechanisms, clinical presentation, and outcomes of pTBI in a developing region.
- To identify key determinants of pTBI to inform policy recommendations for improved pediatric care.
Main Methods:
- A retrospective observational study was conducted.
- Data from pediatric patients (≤18 years) with traumatic brain injury admitted to a level 1 trauma center between 2010-2014 were analyzed.
- Comparisons were made across different pediatric age groups.
Main Results:
- Out of 945 TBI patients, 167 (17.7%) were pediatric. Males constituted 81% of pTBI cases.
- Motor vehicle crashes (47.3%) were the leading cause, particularly among teenagers (77.3%). Falls were common in younger children (infants/toddlers: 51.3%).
- Teenagers (15-18 years) exhibited higher injury severity, prolonged hospital stays, increased complications (pneumonia, sepsis), and the highest mortality rate (13% overall, highest in MVC victims).
Conclusions:
- This study highlights the significant burden of pTBI in the Arab Middle East, with teenagers being the most vulnerable group.
- The findings provide a basis for developing region-specific safety strategies and policies to improve pediatric trauma care.
Background:
The epidemiologic characteristics and outcomes of pediatric traumatic brain injury (pTBI) have not been adequately documented from the rapidly developing countries in the Arab Middle East. We aimed to describe the hospital-based epidemiologic characteristics, injury mechanisms, clinical presentation, and outcomes of pTBI and analyze key characteristics and determinant of pTBI that could help to make recommendations for policies to improve their care.
Methods:
We conducted a retrospective observational study in a level 1 trauma center (2010-2014) for all pTBI patients. Data were analyzed and compared according to different patient age groups.
Results:
Out of 945 traumatic brain injury patients, 167 (17.7%) were ≤ 18 years old with a mean age of 10.6 ± 5.9 and 81% were males. The rate of pTBI varied from 5 to 14 cases per 100,000 children per year. The most affected group was teenagers (15-18 years; 40%) followed by infants/toddlers (≤ 4 years; 23%). Motor vehicle crash (MVC; 47.3%) was the most frequent mechanism of injury followed by falls (21.6%). MVC accounted for a high proportion of pTBI among teenagers (77.3%) and adolescents (10-14 years; 48.3%). Fall was a common cause of pTBI for infants/toddlers (51.3%) and 5-9 years old group (30.3%). The proportion of brain contusion was significantly higher in adolescents (61.5%) and teenagers (58.6%). Teenagers had higher mean Injury Severity Scoring of 24.2 ± 9.8 and lower median (range) Glasgow Coma Scale of 3 (3-15) (P = 0.001 for all). The median ventilatory days and intensive care unit and hospital length of stay were significantly prolonged in the teenage group. Also, pTBI in teenage group showed higher association with pneumonia (46.4%) and sepsis (17.3%) than other age groups (P = 0.01). The overall mortality rate was 13% (n = 22); 11 died within the first 24 h, 7 died between the second and seventh day and 4 died one week post-admission. Among MVC victims, a decreasing trend of case fatality rate (CFR) was observed with age; teenagers had the highest CFR (85.7) followed by adolescents (75.0), young children (33.3), and infants/toddlers (12.5).
Conclusions:
This local experience to describe the burden of pTBI could be a basis to adopt and form an efficient, tailored strategy for safety in the pediatric population.
