Pediatric TBI: Direct admissions vs. secondary referrals to a hospital: A single‑center, retrospective study
Moosa Allawati1,2, Yahya Al-Kindi1,3, Said Al Jaadi1,2
1College of Medicine and Health Sciences, Sultan Qaboos University, Muscat 123, Sultanate of Oman.
Insights
This study compared pediatric traumatic brain injury (TBI) cases. Directly admitted patients had more nausea and vomiting, while referred cases experienced longer hospital stays, indicating differences in TBI severity and management.
Area of Science:
- Pediatric Traumatology
- Neuroscience
- Emergency Medicine
Background:
- Pediatric traumatic brain injury (TBI) presents a significant public health concern.
- Understanding referral patterns and admission sources is crucial for optimizing care.
- Differences between directly admitted and referred pediatric TBI cases require investigation.
Purpose of the Study:
- To compare demographic characteristics, injury causes, and clinical presentations of pediatric TBI patients.
- To analyze differences in hospital admission pathways (direct vs. referral) for pediatric TBI.
- To identify factors associated with severity and outcomes in pediatric TBI.
Main Methods:
- Retrospective review of 981 pediatric TBI cases admitted between January 2015 and December 2019.
- Data collection included patient demographics, presenting complaints, TBI etiology, and admission source.
- Statistical analysis to compare outcomes between directly admitted and referred patient groups.
Main Results:
- Falling was the most common cause of TBI (63.5%).
- Nausea and vomiting were more frequent in directly admitted cases (P≤0.05).
- Referred patients had significantly longer hospital stays (P≤0.001), suggesting more severe injuries.
Conclusions:
- Pediatric TBI cases exhibit distinct characteristics based on admission source.
- Severe pediatric TBI cases are more likely to be referred from other facilities.
- Further multi-center research is needed to validate findings and improve TBI management strategies.
Abstract:
The present retrospective study was conducted in an aim to examine the differences between pediatric traumatic brain injury (TBI) cases referred to and those admitted directly to the hospital. For this purpose, pediatric patients who presented to a main trauma center with TBI between January, 2015 and December, 2019 were reviewed retrospectively, emphasizing whether they were admitted directly or referred from another center. Data collected included the demographic characteristics of the patients, as well as their presenting complaints and the cause of TBI. A total of 981 cases of pediatric TBI were admitted over the 5-year period. The average age of the patients was 58.1 months for the referred cases and almost 50 months for the patients directly admitted. The male sex accounted for 63.6% of all cases. The most common cause of injury was falling (63.5%). Nausea and vomiting were the most typical presenting symptoms, occurring more among the directly admitted cases (P-value ≤0.05). Mild TBI accounted for 85.3% of the cases, and the most common radiological diagnosis was skull fracture (37.4%) (P-value ≤0.004). The referred patients had a more extended hospital stay (P-value ≤0.001). On the whole, the present study identified 981 cases; the majority of these were direct admissions, and the majority of the severe cases were referred from other healthcare facilities. Further research is required on this topic as only a single hospital was covered herein, and patients were not followed-up after discharge. A multi-center analysis would cover a greater number of patients and would thus provide more substantial data on the topic.
