Epidemiology of Pediatric Traumatic Brain Injury in a Dense Urban Area Served by a Helicopter Trauma Service

Hill, Ciaran Scott; McLean, Aaron Lawson; Wilson, Mark

doi:10.1097/pec.0000000000000845

Cited by 8 publications

(14 citation statements)

References 21 publications

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“…Globally, TBI is projected to be the third leading cause of death and injury by the World Health Organization in 2020 [2,5,6]. Pediatric TBI is reported to be the most common cause of injury-related death, and it commonly follows road traffic accidents and falls [7,8]. TBI accounted for 8.3% of the pediatric emergency department (ED) visits with mild severity according to the Western studies [9,10].…”

Section: Introductionmentioning

confidence: 99%

“…Poor TBI outcome was documented in resource-limited settings, and neurocritical protocol for prehospital care was recommended [29]. e TBI mortality rate ranged from 8% in Western settings to 21.2% in the developing regions [7,11,29]. Lack of prospective studies and injury data registries in most parts of Africa has made the assessment of TBI difficult [15].…”

Section: Introductionmentioning

confidence: 99%

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Pattern and Outcome of Pediatric Traumatic Brain Injury at Hawassa University Comprehensive Specialized Hospital, Southern Ethiopia: Observational Cross-Sectional Study

Bedry

Tadele

2020

Emergency Medicine International

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Background. Traumatic brain injury (TBI) is the most common cause of death/disability in children. The Glasgow coma scale and other parameters are used for treatment/follow-up of TBI. Childhood TBI data are scarce from sub-Saharan Africa. The study aimed to determine the pattern and predictors of the TBI outcome in Southern Ethiopia. Methods. An observational cross-sectional study was conducted from September 2017 to September 2018 at Hawassa University Hospital. Structured questionnaires were used for data collection. Significant associations were declared at a P value of <0.05. Results. There were 4,258 emergency room (ER) visits during the study period, and TBI contributed to 317 (7.4%) cases. The mean age of study subjects was 7.66 ± 3.88 years. Boys, predominantly above 5 years of age, comprise 218 (68.8%) of the study subjects with a male to female ratio of 2.2 : 1. Pedestrian road traffic accidents (RTA), 120 (37.9%), and falls, 104 (32.8%), were the commonest causes of TBI. Mild, moderate, and severe TBI were documented in 231 (72.9%), 61 (19.2%), and 25 (7.9%) of cases, respectively. Most of the TBI cases presented within 24 hrs of injury, 258 (81.4%). Recovery with no neurologic deficit, 267 (84.2%); focal neurologic deficit, 30 (9.5%); depressed mentation, 10 (3.2%); and death, 10 (3.2%), were documented. Signs of increased intracranial pressure (ICP) at admission [AOR: 1.415 (95% CI: 1.4058–9.557)], severe TBI [AOR: 2.553 (95% CI: 1.965–4.524)], presence of hyperglycemia [AOR: 2.318 (95% CI: 1.873–7.874)], and presence of contusion, diffuse axonal injury (DAI), or intracranial bleeding on the head computed tomography (CT) scan [AOR: 2.45 (95% CI: 1.811–7.952)] predicted poor TBI outcome. Conclusion. TBI contributed to 7.4% of pediatric ER visits. Pedestrian RTA and falls, early presentation (<24 hours of injury), and mild form of TBI among boys were the most common documented patterns. ICP, hyperglycemia, severe TBI, and presence of contusion, DAI, or intracranial bleeding on head CT predicted poor outcome. Strategies to ensure road safety and to prevent falls and animal-related injuries and TBI follow-up for ICP and glycemic controls are recommended.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Pattern and Outcome of Pediatric Traumatic Brain Injury at Hawassa University Comprehensive Specialized Hospital, Southern Ethiopia: Observational Cross-Sectional Study

Bedry

Tadele

2020

Emergency Medicine International

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“…Traumatic brain injury (TBI) amongst children is quite common, with estimates of three million affected children globally every year and 35,000 annual hospitalisations in the United Kingdom (1,2). A New Zealand birth cohort starting in 1977 showed that before the age of 26, 151 people (1%) had been admitted to hospital for TBI (3).…”

Section: Introductionmentioning

confidence: 99%

Epidemiology of paediatric moderate and severe traumatic brain injury in the Netherlands

Jochems

Rein

Niemeijer

et al. 2021

European Journal of Paediatric Neurology

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“…Globally TBI is projected to be the third leading cause of death and injury by world health organization in 2020 [2,5,6]. Pediatric TBI is reported to be the common cause of injury related death, and it commonly follows road traffic accidents and falls [7,8]. Western studies documented TBI contributing for 8.3% of pediatric emergency department(ED) visits, and commonly with mild severity [9,10].…”

Section: Introductionmentioning

confidence: 99%

“…Outcome of TBI varied in resource limited settings and neurocritical protocol for prehospital care was recommended [29]. Mortality rate ranged from 8% in western settings to 21.2% in developing regions [7,11,29]. Lack of prospective studies and injury data registries in most parts of Africa has made the assessment of TBI difficult [15].…”

Section: Introductionmentioning

confidence: 99%

Pattern and Outcome of Pediatric Traumatic Brain Injury: A Prospective Cohort Study at Hawassa University Comprehensive Specialized Hospital, Southern Ethiopia

Bedry

Tadele

2019

Preprint

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Background Traumatic brain injury (TBI), a major public health problem, is the most common cause of death/disability in children. Glasgow coma scale is used to assess, decide treatment and follow up of TBI. TBI causes and outcome data are scarce from sub-Saharan Africa, non-existent from Ethiopia. We aimed to document pattern and predictors of childhood TBI outcome in a teaching hospital, Southern Ethiopia. METHODS Prospective cohort study was conducted from September 2017 to September 2018 among pediatrics TBI presented to Hawassa University Hospital. Data were collected by structured questionnaires and analyzed using SPSS version 20. Logistic regression was carried out and significant associations were declared at p-value of < 0.05. RESULT During 1year period there were 4258 emergency room(ER) visits, TBI contributed to 317(7.4%) cases. The mean age of study subjects was 7.66±3.88 years. Boys, predominantly above 5years of age, comprise 218(68.8%) of study subjects with male to female ratio of 2.2:1. Pedestrian RTA 119 (37.5%) and falls 104 (32.8%) were the commonest causes of TBI. Mild, moderate, and severe TBI were documented in 231(72.9%), 61(19.2%), and 25(7.9%) of cases respectively. Most of TBI cases presented within 24hrs of injury 258(81.4%). Recovery with no neurologic deficit, 267(84.2%); focal neurologic deficit, 30(9.5%); depressed mentation, 10(3.2%) and death 10(3.2%) were documented. Presence of increased intracranial pressure(ICP) at admission [AOR: 1.415 (95% CI: 0.458-9.557)], severe TBI [AOR: 2.103 (95% CI: 0.965-4.524)], presence of hyperglycemia [AOR: 2.318 (95% CI: 0.873-7.874)] and head computed tomographic(CT) scans of contusion, diffuse axonal injury (DAI) or intracranial bleeding [AOR: 2.45 (95% CI: 0.811-7.952)] were found to be predictors of TBI outcome. CONCLUSION TBI contributed to 7.4% of pediatric ER visits. Boys above 5years of age were highly affected. Pedestrian RTA and falls, early presentation (<24hrs of injury) and mild form of TBI were the common documented patterns. Presence of increased ICP, hyperglycemia, severe TBI and CT findings of contusion, DAI/intracranial bleeding were predictors of poor outcome. Public awareness on road safety, childhood safety in preventing falls/animal injuries, closer follow-up of TBI cases for ICP and glycemic controls are recommended.

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Epidemiology of Pediatric Traumatic Brain Injury in a Dense Urban Area Served by a Helicopter Trauma Service

Abstract: An improved understanding of the epidemiology of pediatric brain injury will provide baselines for future outcome measurement and comparative analysis. This may improve service organization and delivery.

Cited by 8 publications

References 21 publications

Pattern and Outcome of Pediatric Traumatic Brain Injury at Hawassa University Comprehensive Specialized Hospital, Southern Ethiopia: Observational Cross-Sectional Study

Pattern and Outcome of Pediatric Traumatic Brain Injury at Hawassa University Comprehensive Specialized Hospital, Southern Ethiopia: Observational Cross-Sectional Study

Epidemiology of paediatric moderate and severe traumatic brain injury in the Netherlands

Pattern and Outcome of Pediatric Traumatic Brain Injury: A Prospective Cohort Study at Hawassa University Comprehensive Specialized Hospital, Southern Ethiopia

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