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Murine Model of Controlled Cortical Impact for the Induction of Traumatic Brain Injury
Published on: August 16, 2019
Hospitalization and Morbidity Rates After Pediatric Traumatic Brain Injury: A Nation-Wide Population-Based Analysis
Nora Bruns1,2, Pietro Trocchi3, Ursula Felderhoff-Müser1,2
1Department of Pediatrics I, Pediatric Intensive Care Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.
Insights
Pediatric traumatic brain injury (TBI) is common in Germany, but severe outcomes like neurosurgery and mortality are rare. Further research is needed to understand hospitalization reasons and reduce unnecessary admissions.
Area of Science:
- Pediatric neurology
- Public health
- Epidemiology
Background:
- Traumatic brain injury (TBI) is a significant global cause of child morbidity and mortality.
- Nation-wide data on the pediatric TBI burden is limited.
Purpose of the Study:
- To assess the incidence and outcomes of pediatric TBI hospitalizations in Germany.
- To analyze rates of imaging, intracranial injury, neurosurgery, and mortality.
Main Methods:
- Utilized nation-wide hospital data (Diagnosis Related Groups) for children (<18 years) in Germany (2014-2018).
- Calculated crude, age-specific, and standardized incidence rates for hospitalizations, imaging, intracranial injury, neurosurgery, and mortality.
Main Results:
- Identified 458,844 pediatric TBI hospitalizations (crude incidence: 687/100,000 child years).
- Computed tomography rates increased with age, reaching 162/100,000 CY by age 17.
- Intracranial injury (2.7%), neurosurgery (0.7%), mechanical ventilation (0.7%), and mortality (0.1%) rates were low.
Conclusions:
- Pediatric TBI hospitalizations in Germany are substantial, but severe outcomes are infrequent.
- Low rates of imaging, ventilation, surgery, and mortality suggest potential for optimizing care.
- Further investigation into hospitalization drivers and strategies for reducing unnecessary admissions is warranted.
Abstract:
Background: Even though traumatic brain injury (TBI) is a major cause of morbidity and mortality in children around the globe, population-based and nation-wide data to assess the burden of TBI is scarce. Methods:Based on diagnosis related groups from nation-wide hospital data, we extracted data on all TBI-related hospitalizations in children <18 years in Germany between 2014 and 2018. We calculated crude, age-specific and standardized incidence rates for hospitalizations, imaging, intracranial injury, neurosurgery, and mortality. Results:Out of 10.2 million hospitalizations, we identified 458,844 cases with TBI as primary or secondary diagnosis, resulting in a crude incidence rate of 687/100,000 child years (CY). Age-specific rates of computed tomography were below 30/100,000 CY until the age of 10 years and increased to 162/100,000 CY until 17 years of age. Intracranial injury was diagnosed in 2.7%, neurosurgery was performed in 0.7% of patients, and 0.7% were mechanically ventilated. Mortality was 0.67/100,000 CY (0.1%). Conclusions:Despite substantial hospitalization rates for pediatric TBI in Germany, the rates of imaging, the need for mechanical ventilation, neurosurgery and mortality were overall very low. Reasons for hospitalization and measures to reduce unnecessary admissions warrant further investigation.
