Risk factors for late complications in pediatric penetrating brain injuries: a retrospective study

Pediatric penetrating brain injuries (PBIs) represent a significant public health challenge among children, contributing substantially to global morbidity and mortality. The long-term complications following such trauma can profoundly affect the psychological and physical development of affected children. This study aims to investigate the risk factors associated with late complications resulting from penetrating brain injuries in pediatric patients.

This single-center retrospective cohort study included 30 children with PBIs. Among these, 19 cases involved penetrating brain injuries caused by metallic objects (such as rebar, nails, darts, and scissors), while the remaining 11 cases were due to wooden materials (such as branches and chopsticks). Clinical and laboratory data were collected and systematically analyzed. Both univariate and multivariate analyses were conducted on the variables.

In the univariate analysis, the severity of brain-penetrating injury (OR = 3.864, p = 0.038) and the depth of penetration (OR = 5.867, p = 0.001) are identified as significant risk factors for delayed complications. In the multivariate analysis, depth of penetration (OR 8.132, p = 0.012) was identified as an independent risk factor for the incidence of delayed complications. Statistical analysis using Fisher's exact test revealed that the type of material (p = 0.003) and the entry point (p = 0.018) are significant factors associated with late epilepsy.

Depth of penetration may be associated with late complications. The material of the injury and entry point are associated with the late epilepsy. However, due to the small sample size and limited control of confounding factors, this association is exploratory and requires confirmation through larger prospective or multicenter studies.