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Age predicts likelihood for surgery for pediatric tbi: an analysis of 1745 hospitlizations from a Chinese Children's
Jiangshun Fang1, Tony Xing Tan2, Emily Ferron3
1Department of Pediatric Neurosurgery, Children's Hospital of Hebei Province, Shijiazhuang, Hebei, China.
Insights
Younger children with traumatic brain injuries (TBI) were less likely to receive surgery, regardless of injury severity. Child sex did not influence surgical intervention decisions in this pediatric neurotrauma study.
Area of Science:
- Pediatric neurosurgery
- Trauma surgery
- Pediatric neurology
Background:
- Traumatic brain injury (TBI) is a significant cause of morbidity and mortality in children.
- Surgical intervention is a critical treatment modality for severe TBI, but factors influencing its use in pediatric populations require further investigation.
- Understanding demographic and clinical predictors of surgical intervention is essential for optimizing care pathways.
Purpose of the Study:
- To investigate the influence of age and sex on the likelihood of receiving surgical intervention following hospitalization for pediatric traumatic brain injury (TBI).
- To identify demographic and clinical factors associated with surgical intervention in pediatric TBI patients.
Main Methods:
- Retrospective analysis of 1745 children hospitalized at a pediatric neurotrauma center in China.
- Data collected included age, sex, injury details, Glasgow Coma Scale (GCS) score, mortality, Glasgow Outcome Scale (GOS) score, and surgical intervention.
- Logistic regression analysis was performed on 1027 children with specific intracranial hemorrhages to determine predictors of surgery.
Main Results:
- Younger children (0-13 years) showed a statistically significant lower odds of receiving surgery for epidural hematomas (OR=0.75), subdural hematomas (OR=0.59), and intraventricular hemorrhage (OR=0.52).
- Injury severity and type were expected predictors for surgery.
- The sex of the child was not found to be related to surgical intervention.
Conclusions:
- Age is a significant independent predictor of surgical intervention in pediatric TBI, with younger children being less likely to undergo surgery.
- While TBI severity and type are crucial, age plays a distinct role in surgical decision-making for pediatric TBI.
- Future research should explore the underlying reasons for age-related disparities in surgical treatment for pediatric TBI.
Purpose:
We tested the role of age and sex in surgery following pediatric TBI hospitalization.
Methods:
Records of 1745 children hospitalized at a pediatric neurotrauma center in China included age, sex, cause of injury, diagnosis of injury, days of hospitalization, in-house rehabilitation, Glasgow Coma Scale score, mortality, 6-month post-discharge Glasgow Outcome Scale score, and surgery intervention. The children were 0-13 years (M= 3.56 years; SD = 3.06), with 47.4% 0-2 years of age.
Results:
The mortality rate was 1.49%. Logistic regression on 1027 children with epidural hematoma, subdural hematoma, intracerebral hemorrhage, and intraventricular hemorrhage showed that controlling for other variables, the odds for younger children to receive surgery was statistically lower for epidural hematomas (OR = 0.75; 95% CI = 0.68-0.82), subdural hematomas (OR = 0.59; 95% CI = 0.47-0.74), and intraventricular hemorrhage (OR = 0.52; 95% CI = 0.28-0.98).
Conclusions:
While severity of TBI and type of TBI were expected predictors for surgery, a younger age also predicted a significantly lower likelihood of surgery in our sample. Sex of the child was unrelated to surgical intervention.
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