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Is Diffuse Axonal Injury Different in Adults and Children? An Analysis of National Trauma Database
Yehuda Hershkovitz1, Boris Kessel2, J J Dubose3
1From the Department of Surgery, Shamir Medical Center, Zeriffin, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv.
Pediatric Emergency Care
|February 1, 2022
Summary
Pediatric patients with diffuse axonal injury (DAI) experience better outcomes and fewer associated injuries compared to adults. This study highlights key differences in recovery and injury patterns between pediatric and adult DAI cases.
Area of Science:
- Neuroscience
- Trauma Surgery
- Pediatric Neurology
Background:
- Diffuse axonal injury (DAI) results from acceleration-deceleration forces impacting brain tissue.
- Prognosis of DAI is under investigation, with limited data on pediatric versus adult outcomes.
Purpose of the Study:
- To compare demographic and outcome differences in pediatric and adult patients diagnosed with diffuse axonal injury.
- To investigate the impact of age on DAI prognosis and associated injuries.
Main Methods:
- Retrospective cohort study of blunt trauma patients with DAI (1997-2018) from the Israeli National Trauma Registry.
- Patients were categorized into pediatric (<15 years) and adult (>15 years) groups for comparative analysis.
Main Results:
- DAI occurred in 1983 patients (23.6% pediatric, 76.4% adult).
- Adults exhibited higher Injury Severity Scores, increased mortality, longer hospitalizations, and greater need for rehabilitation.
- Adults also presented with more frequent extracranial injuries, particularly to the chest.
Conclusions:
- Pediatric patients with DAI demonstrate improved outcomes compared to adult patients.
- Children with DAI experience fewer associated injuries than their adult counterparts.
