Risk of infection and sepsis in pediatric patients with traumatic brain injury.
In the United States, 29% of trauma-related deaths in children are caused by traumatic brain injury (TBI). In general, TBI is associated with an increased risk of developing sepsis, which is a life-threatening illness caused by the body’s chemical response to an infection. Current research suggests that up to 75% of adults with severe TBI will develop sepsis and that these patients are at significantly higher risk of death compared to patients without the condition. Unfortunately, the relationship between TBI and sepsis in children is not well understood, despite the high incidence of TBI in pediatric populations.
To address this gap in the research, a recent Canadian study examined the association between TBI and sepsis in more than 2,500 children younger than 18 years old. They found that the overall rate of sepsis and infection in children was low relative to the typical rate of sepsis in adults. Unlike adults with TBI, who are at high risk of developing sepsis, children with TBI were not more likely to develop sepsis than children without TBI. The overall mortality rate in this population was 3%, but sepsis was not associated with an increased risk of mortality.
Contrary to previous findings in studies of brain-injured adults, children with TBI do not appear to be at higher risk of sepsis and overall infection. Overall, children are less likely to develop sepsis and infection after sustaining TBI than adults, up to 80% of whom may develop these conditions. Further research is necessary to determine the biological mechanisms underlying these age differences.
Pandya A, Chaput KH, Schertzer A, et al. Risk of infection and sepsis in pediatric patients with traumatic brain injury admitted to hospital following major trauma. Scientific Reports. (May 2018).