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Epidemiology of Neurotrauma in Pediatric Intensive Care Unit: A Single-center Experience of 10 Years
Chandrakant G Pujari1, A V Lalitha1, John M Raj2
1Department of Pediatric Intensive Care Unit, St. John's Medical College Hospital, Bengaluru, Karnataka, India.
Insights
Pediatric traumatic brain injury (TBI) is a major concern, especially in children under 5. A low pediatric trauma score (PTS) and polytrauma are key predictors of poor outcomes in pediatric neurotrauma.
Area of Science:
- Pediatric neurotrauma research
- Clinical epidemiology of TBI
Background:
- Traumatic brain injury (TBI) in children presents unique challenges compared to adults.
- There is a growing need to understand the clinical and epidemiological aspects of pediatric neurotrauma.
Purpose of the Study:
- To investigate the clinicoepidemiological profile of pediatric neurotrauma.
- To determine the outcomes associated with pediatric TBI.
Main Methods:
- A single-center retrospective study was conducted in a pediatric intensive care unit (PICU).
- Data from 316 children (1 month to 18 years) with TBI between 2012 and 2022 were analyzed.
- Demographic, clinical, and laboratory data were collected to identify mortality predictors.
Main Results:
- The study included 316 children with TBI; 49.1% were under 5 years old, and 68% were male.
- Falls (53.5%) were the most common cause of injury. Overall mortality was 8.9%, highest in severe TBI (31.6%) and children under 5 (42.9%).
- A lower pediatric trauma score (PTS) and polytrauma were significant predictors of mortality.
Conclusions:
- Traumatic brain injury significantly impacts the pediatric population, with a higher risk in those under 5 years.
- Lower PTS and polytrauma are critical indicators of poor outcomes in pediatric TBI.
Background:
Traumatic brain injury (TBI) in children can lead to grave consequences. The mechanism, mode, and management of pediatric neurotrauma are different from adult neurotrauma, and there is a growing demand to study the clinicoepidemiology of pediatric TBI.
Objective:
To explore the clinicoepidemiological profile and outcome of pediatric neurotrauma.
Methods:
This single-center retrospective study was conducted at a tertiary referral hospital in the PICU involving children (1 month to 18 years) sustaining TBI (2012-2022). Demographic, clinical, and laboratory details at the onset of admission were collected. Predictors of mortality were compared between survivors and non-survivors.
Results:
Demographic, clinical, and laboratory data of 316 children with traumatic brain injuries at admission were collected and analyzed. The median (IQR) age was 72 months (36-132 months), with 68% of the cohort being male. The majority of the study population (49.1%) was under the age of 5 years. Injury from a fall was the most frequent mechanism of injury (53.5%), followed by road traffic accidents (5%). More than half of the study population suffered mild-TBI (55%). The overall mortality was 8.9% (28/316), and it was highest in the severe TBI group (31.6%) and under-5 years population (42.9%). Lower pediatric trauma score (PTS) (AOR: 0.52; 95% CI: 0.34-0.82) and polytrauma were significantly associated with mortality (AOR: 4.61; 95% CI: 1.02-20.86).
Conclusion:
Traumatic brain injury is a significant concern in the pediatric population, particularly those under the age of 5 years. Lower PTS and polytrauma predicted poor outcome.
How To Cite This Article:
Pujari CG, Lalitha AV, Raj JM, Ashwini A Meshram. Epidemiology of Neurotrauma in Pediatric Intensive Care Unit: A Single-center Experience of 10 Years. Indian J Crit Care Med 2025;29(1):59-64.
