Pediatric moderate and severe traumatic brain injury - A national, population-based cohort study

Trym Kolstø ¹, David Werner ², Kenneth Thorsen ^3,4

⁰Department of Neurology, Stavanger University Hospital, Stavanger, Norway. trymkolsto@gmail.com.

European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society +

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October 30, 2025

View abstract on PubMed

Summary

Pediatric traumatic brain injury (TBI) in Norway shows a low mortality rate, with most children experiencing good outcomes. Further research into evidence-based interventions is crucial for optimizing recovery and functional independence in young patients.

Area Of Science

Pediatric Traumatology
Neuroscience
Public Health Epidemiology

Background

Traumatic brain injury (TBI) is a significant cause of morbidity and mortality in children.
Understanding the epidemiology and outcomes of pediatric TBI is crucial for developing effective prevention and treatment strategies.

Purpose Of The Study

To investigate the epidemiological characteristics of pediatric moderate and severe traumatic brain injury (TBI).
To identify common injury mechanisms and analyze clinical outcomes in pediatric TBI patients.
To utilize population-based data from a national trauma registry for comprehensive analysis.

Main Methods

A nationwide observational cohort study was conducted.
Data were collected from the Norwegian Trauma Registry between January 1, 2017, and December 31, 2020.
Included were all pediatric patients (0-17 years) diagnosed with moderate or severe TBI.

Main Results

A total of 348 pediatric patients with moderate (83%) and severe (17%) TBI were analyzed.
High-energy falls (33%) and road traffic accidents (29%) were the most frequent injury mechanisms.
The 30-day mortality rate was 3%, with significantly higher rates in severe TBI (12%) compared to moderate TBI (1%). Severe TBI cases also involved longer hospital stays and poorer functional recovery.

Conclusions

This population-based study highlights a relatively low mortality rate for pediatric TBI in Norway over a four-year period.
Approximately 80% of pediatric TBI patients achieved good functional outcomes (moderate, low, or no disability).
Further research into evidence-based interventions is essential to prevent primary and secondary injuries, optimize recovery, and enhance functional independence in pediatric TBI survivors.

Keywords:

Abbreviated injury scale Functional outcome Glasgow outcome score Moderate TBI Pediatric traumatic brain injury Severe TBI