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The epidemiology of and management of pediatric patients with head trauma : a hospital-based study from Southern Sweden

Al Mukhtar, Ali LU ; Bergenfeldt, Henrik LU ; Edelhamre, Marcus LU ; Vedin, Tomas LU ; Larsson, Per Anders LU and Öberg, Stefan LU (2022) In Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 30(1).
Abstract

Background: Traumatic brain injury (TBI) is a common cause of morbidity and mortality in children worldwide. In Scandinavia, the epidemiology of pediatric head trauma is poorly documented. This study aimed to investigate and compare the epidemiology and management of pediatric patients with isolated head trauma (IHT) and head trauma in connection with multitrauma (MHT). Methods: We conducted a retrospective review of medical records of patients < 18 years of age who attended any of the five emergency departments (ED) in Scania County in Sweden in 2016 due to head trauma. Clinical data of patients with IHT were analyzed and compared with those of patients with MHT. Results: We identified 5046 pediatric patients with head trauma, 4874... (More)

Background: Traumatic brain injury (TBI) is a common cause of morbidity and mortality in children worldwide. In Scandinavia, the epidemiology of pediatric head trauma is poorly documented. This study aimed to investigate and compare the epidemiology and management of pediatric patients with isolated head trauma (IHT) and head trauma in connection with multitrauma (MHT). Methods: We conducted a retrospective review of medical records of patients < 18 years of age who attended any of the five emergency departments (ED) in Scania County in Sweden in 2016 due to head trauma. Clinical data of patients with IHT were analyzed and compared with those of patients with MHT. Results: We identified 5046 pediatric patients with head trauma, 4874 with IHT and 186 with MHT, yielding an incidence of ED visits due to head trauma of 1815/100,000 children/year. There was male predominance, and the median age was four years. Falls were the dominating trauma mechanism in IHT patients, while motor vehicle accidents dominated in MHT patients. The frequencies of CT head-scans, ward admissions and intracranial injuries (ICI) were 5.4%, 11.1% and 0.7%, respectively. Four patients (0.08%) required neurosurgical intervention. The relative risks for CT-scans and admissions to a hospital ward and ICI were 10, 4.5 and 19 times higher for MHT compared with IHT patients. Conclusion: Head trauma is a common cause of ED visits in our study. Head-CTs and ICIs were less frequent than in previous studies. MHT patients had higher rates of CT-scans, admissions, and ICIs than IHT patients, suggesting that they are separate entities that should ideally be managed using different guidelines to optimize the use of CT-scans of the head.

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author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Computed tomography, Isolated head trauma, Multitrauma, Pediatric traumatic brain injury
in
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
volume
30
issue
1
article number
67
publisher
BioMed Central (BMC)
external identifiers
  • scopus:85143594542
  • pmid:36494828
ISSN
1757-7241
DOI
10.1186/s13049-022-01055-9
language
English
LU publication?
yes
id
948583eb-e179-4f08-acf5-0441ceb3b2f5
date added to LUP
2022-12-23 09:06:29
date last changed
2024-06-26 02:03:57
@article{948583eb-e179-4f08-acf5-0441ceb3b2f5,
  abstract     = {{<p>Background: Traumatic brain injury (TBI) is a common cause of morbidity and mortality in children worldwide. In Scandinavia, the epidemiology of pediatric head trauma is poorly documented. This study aimed to investigate and compare the epidemiology and management of pediatric patients with isolated head trauma (IHT) and head trauma in connection with multitrauma (MHT). Methods: We conducted a retrospective review of medical records of patients &lt; 18 years of age who attended any of the five emergency departments (ED) in Scania County in Sweden in 2016 due to head trauma. Clinical data of patients with IHT were analyzed and compared with those of patients with MHT. Results: We identified 5046 pediatric patients with head trauma, 4874 with IHT and 186 with MHT, yielding an incidence of ED visits due to head trauma of 1815/100,000 children/year. There was male predominance, and the median age was four years. Falls were the dominating trauma mechanism in IHT patients, while motor vehicle accidents dominated in MHT patients. The frequencies of CT head-scans, ward admissions and intracranial injuries (ICI) were 5.4%, 11.1% and 0.7%, respectively. Four patients (0.08%) required neurosurgical intervention. The relative risks for CT-scans and admissions to a hospital ward and ICI were 10, 4.5 and 19 times higher for MHT compared with IHT patients. Conclusion: Head trauma is a common cause of ED visits in our study. Head-CTs and ICIs were less frequent than in previous studies. MHT patients had higher rates of CT-scans, admissions, and ICIs than IHT patients, suggesting that they are separate entities that should ideally be managed using different guidelines to optimize the use of CT-scans of the head.</p>}},
  author       = {{Al Mukhtar, Ali and Bergenfeldt, Henrik and Edelhamre, Marcus and Vedin, Tomas and Larsson, Per Anders and Öberg, Stefan}},
  issn         = {{1757-7241}},
  keywords     = {{Computed tomography; Isolated head trauma; Multitrauma; Pediatric traumatic brain injury}},
  language     = {{eng}},
  number       = {{1}},
  publisher    = {{BioMed Central (BMC)}},
  series       = {{Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine}},
  title        = {{The epidemiology of and management of pediatric patients with head trauma : a hospital-based study from Southern Sweden}},
  url          = {{http://dx.doi.org/10.1186/s13049-022-01055-9}},
  doi          = {{10.1186/s13049-022-01055-9}},
  volume       = {{30}},
  year         = {{2022}},
}