Epidemiology of paediatric moderate and severe traumatic brain injury in the Netherlands

Area of Science:

• Pediatric Traumatology
• Epidemiology
• Public Health

Background:

• Traumatic brain injury (TBI) is a leading cause of death globally in children.
• Previous Dutch epidemiological data on pediatric TBI is over a decade old.
• Understanding current incidence, injury mechanisms, and outcomes is crucial for reducing TBI impact.

Purpose of the Study:

• To determine the current incidence of moderate-severe TBI in children in the Netherlands.
• To analyze the mechanisms of injury across different pediatric age groups.
• To assess outcomes and mortality rates associated with pediatric TBI.

Main Methods:

• Nationwide retrospective cohort study using the Dutch National Trauma Database.
• Inclusion of patients aged 18 years and younger with moderate-severe TBI (Abbreviated Injury Score≥3) admitted between January 2015 and December 2017.
• Subanalyses performed for distinct pediatric age groups.

Main Results:

• 1413 pediatric patients were included; 5% mortality rate.
• Overall incidence of moderate-severe TBI was 14 per 100,000 person-years.
• Falls were the most frequent cause in younger children (<5 years), while road traffic accidents (RTAs), predominantly bicycle-related, were more common in older children (≥10 years).
• Mortality and poor outcomes (Glasgow Outcome Scale score of 3) increased with age.

Conclusions:

• Moderate-severe TBI in children remains a significant public health issue in the Netherlands.
• Injury mechanisms vary by age, with falls prevalent in younger children and RTAs in older children.
• Bicycle accidents represent a notable proportion of RTAs in pediatric TBI cases in the Netherlands.