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Mortality and morbidity of severe traumatic brain injuries: A pediatric intensive care unit experience over 15 years

Experts estimate that traumatic brain injury (TBI) will become the leading cause of death and disability by 2020. TBI poses a significant public health problem for children, more than a million of whom die every year as a result of these injuries. Because TBI is so prevalent in this population, researchers are highly motivated to understand the factors associated with mortality, morbidity, hospitalization, and outcomes following pediatric TBI. These data inform the development of new interventions and prevention efforts, which can significantly reduce TBI among children.

A research team in China contributed to this effort by reviewing hospital records from children who were admitted to the pediatric intensive care unit (PICU) for accidental TBI, which most commonly results from falls or vehicle collisions. Over a 15-year period, 95 children (78% of whom were boys) were admitted to the PICU for TBI at a regional trauma center in Hong Kong. More than half of these injuries were caused by falls, most of which occurred in the home. Children who sustained TBI from falling were typically younger and were more likely to die as a result of their injuries. Compared to children who fell, children who were injured in road traffic accidents were more likely to suffer from skull fractures, but none of these children died. Among all of the patients, children stayed in the PICU significantly longer when they had brain bleeds, needed mechanical breathing support, or required neurological interventions.

In Hong Kong, children who sustain TBI are usually injured after falling or experiencing a vehicle accident. Although cause of injury varies by age group, boys are significantly more likely than girls to sustain these injuries. The researchers note that high TBI prevalence among boys is common worldwide, perhaps because boys undergo different gender socialization related to injury beliefs and risk-taking behaviors. Regardless of the cause of this gender gap, clinicians are advised to develop targeted TBI education campaigns specifically for adolescent boys.

Hon KL, Huang S, Poon WS, et al. Mortality and morbidity of severe traumatic brain injuries: A pediatric intensive care unit experience over 15 years. Bulletin of Emergency and Trauma. (2019).


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