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Mortality And Morbidity of Severe Traumatic Brain Injuries; A Pediatric Intensive Care Unit Experience Over 15 Years

Kam Lun Hon1, Siwei Huang2, Wai Sang Poon3

  • 1Department of Pediatrics, The Chinese University of Hong Kong, Hong Kong.

Bulletin of Emergency and Trauma
|August 9, 2019
PubMed

Insights

Accidental pediatric traumatic brain injury (TBI) in an Asian city primarily affects boys and is linked to longer intensive care stays due to specific hemorrhages and treatments. Preventive education targeting males is recommended.

Area of Science:

  • Pediatric intensive care
  • Traumatology
  • Neuroscience

Background:

  • Accidental traumatic brain injury (TBI) is a significant cause of morbidity and mortality in children.
  • Understanding factors influencing length of stay (LOS) in pediatric intensive care units (PICUs) is crucial for resource allocation and patient management.
  • Pediatric TBI demographics and injury patterns can vary significantly by geographic region.

Purpose of the Study:

  • To investigate mortality, morbidity, and types of intracranial hemorrhages in children with accidental TBI.
  • To identify factors associated with prolonged LOS in a PICU setting.
  • To compare injury patterns and outcomes between road traffic injuries (RTI) and falls in pediatric TBI.

Main Methods:

  • Retrospective review of pediatric patients admitted to a PICU with accidental TBI (RTI and falls) between 2002 and 2017.
  • Exclusion of non-accidental injuries (NAI).
  • Demographic and clinical data analysis, including comparison between RTI and fall groups.

Main Results:

  • 95 children with accidental TBI (78% males) were admitted, representing 3.7% of PICU admissions.
  • RTI victims were older and more likely to have skull fractures than fall victims.
  • Subarachnoid and extradural hemorrhages, mechanical ventilation, inotropes, and neurological support correlated with longer PICU LOS.

Conclusions:

  • Specific intracranial hemorrhages and intensive care interventions are associated with extended PICU LOS in pediatric TBI from RTI and falls.
  • The majority of pediatric TBI cases in this cohort were male.
  • Targeted preventive health education for boys is suggested to mitigate severe TBI incidence.
Abstract

Keywords:
FallsLength of StayMortalityPICURoad traffic injuryTraumatic Brain injury

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