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Fall-related traumatic brain injury in a Nigerian pediatric population
James A Balogun1, Aliyu M Koko2, Adegboyega Adebayo3
1Division of Neurosurgery, Department of Surgery, College of Medicine, University of Ibadan, Nigeria; Department of Neurosurgery, University College Hospital, Ibadan, Nigeria.
Insights
Pediatric falls are a major cause of traumatic brain injury (TBI) in Nigeria. Older children are more likely to fall from trees, leading to severe injuries and higher mortality rates.
Area of Science:
- Pediatric Traumatology
- Neuroscience
- Public Health
Background:
- Accidental falls represent a significant cause of pediatric disability and mortality.
- Falls contribute to a substantial number of emergency hospital admissions for children.
- This study focuses on falls-related traumatic brain injury (TBI) in Nigerian children.
Purpose of the Study:
- To assess clinical characteristics of pediatric falls-related TBI in Nigeria.
- To evaluate management outcomes for pediatric falls-related TBI.
- To identify factors associated with falls-related TBI in Nigerian children.
Main Methods:
- A retrospective analysis of pediatric patients under 18 years old over a two-year period.
- Data collected from three major Nigerian centers via clinical records and neurosurgical data sheets.
- Statistical analysis included descriptive statistics, Chi-square test, and multinomial regression (p < 0.05).
Main Results:
- 128 children with fall-related TBI were identified; median age 96 months, male to female ratio 6:1.
- 40.6% had moderate head injury; 55.5% of falls were building-related. 42.6% sustained skull fractures.
- Older children more frequently fell from trees, experiencing severe head injury (14.1%) and higher mortality (10% in children >5 years).
Conclusions:
- Traumatic brain injury from falls is a prevalent issue among Nigerian children.
- Older children are at higher risk from falls from trees, associated with increased mortality.
- Falls from buildings were common in younger children (0-5 years) and led to early presentation.
Background:
Accidental falls are a common cause of disability and trauma-related death in the pediatric population, accounting for a large number of pediatric emergency hospital admissions. This multicenter study assesses the clinical characteristics, management outcomes of pediatric falls-related traumatic brain injury and associated factors in Nigeria.
Methods:
A retrospective study of pediatric patients (age less than 18-years) with falls over a 2-year period. Data was extracted from clinical records and neurosurgical data sheets from three major centres in Nigeria, and was analyzed using descriptive statistics, Chi square test and multinomial regression with significance set at p < 0.05.
Results:
128 children presented with fall-related TBI, with a median age of 96 months (age range of 5-216 months) and M:F was 6:1. 40.6 % had moderate head injury and 55.5 % of the falls were building related. There were 52(42.6 %) children with skull fractures. Older children more commonly fell from trees and had more cases of severe head injury (14.1 %) compared with those who fell from buildings (5.5 %). Children who fell from buildings presented early (64.1 %). The 10 % mortality was mainly in children older than 5-years. Children aged 0-5 years were three times likely to fall inside/outside a building (OR: 3.3, CI: 3.06 to 243.44). Also, those who fell from trees were 6 times more likely to have a long bone fracture (OR: 6.1, CI: 1.2 to 32.6).
Conclusions:
In the Nigerian population Traumatic Brain Injury from falls is common among children, with older children falling more from trees and associated with high mortality.
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