Demographic profile of severe traumatic brain injury admissions to Red Cross War Memorial Children’s Hospital, 2006 - 2011

Schrieff, Leigh; Thomas, Kevin G. F.; Dollman, Aimee K; Rohlwink, Ursula K.; Figaji, Anthony

doi:10.7196/samj.7137

Cited by 34 publications

(45 citation statements)

References 23 publications

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“…Outcomes for TBI in children are by and large good. [9,[11][12][13][14][15] Mortality was associated with low GCS on admission and was confined to the MVA and PVA cohorts. However, this gives a false sense of the severity of TBI.…”

Section: Discussionmentioning

confidence: 99%

“…However, globally it would appear that in contrast to other public health problems such as cardiac diseases and infectious diseases, TBI has not been subject to adequate investigation or surveillance. [11][12][13][14][15][16][17][18] SA, with its excessive trauma burden, is typical in this regard. There is no national trauma registry to track the epidemic in general and there are only a handful of local reports and audits which document the situation as it pertains to TBI in SA.…”

Section: Researchmentioning

confidence: 99%

“…There is no national trauma registry to track the epidemic in general and there are only a handful of local reports and audits which document the situation as it pertains to TBI in SA. [11][12][13][14][15] In addition, there are specific vulnerable population groups such as women, children and adolescents which have been inadequately investigated. TBI is an epidemic that is largely ignored, despite being reported on.…”

Section: Researchmentioning

confidence: 99%

“…[11][12][13][14][15][16][17][18] It is hoped that this audit will provide useful data to the various stakeholders who need to come together to combat this neglected epidemic.…”

Section: Researchmentioning

confidence: 99%

See 3 more Smart Citations

The spectrum and outcome of paediatric traumatic brain injury in KwaZulu-Natal Province, South Africa has not changed over the last two decades

et al. 2017

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Section: Discussionmentioning

confidence: 99%

Section: Researchmentioning

confidence: 99%

Section: Researchmentioning

confidence: 99%

“…[11][12][13][14][15][16][17][18] It is hoped that this audit will provide useful data to the various stakeholders who need to come together to combat this neglected epidemic.…”

Section: Researchmentioning

confidence: 99%

See 2 more Smart Citations

The spectrum and outcome of paediatric traumatic brain injury in KwaZulu-Natal Province, South Africa has not changed over the last two decades

et al. 2017

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“…The majority involve pedestrians (PMVCs), and traumatic brain injury accounts for up to 80% of childhood trauma deaths. [6][7][8][9] In addition to the burden of motor vehicle-related injuries, studies from Nigeria and SA have shown that gunshot wounds (GSWs) in infants and children are a tragic emerging mechanism of injury. [8,10,11] Although the number of hospital admissions following GSWs in Cape Town decreased between 2000 and 2007, the vast majority of deaths occurred before treatment could be instituted and a steady increase in admissions was seen in the subsequent 3 years.…”

mentioning

confidence: 99%

The wrong and wounding road: Paediatric polytrauma admitted to a level 1 trauma intensive care unit over a 5-year period

Naidoo

Muckart

2015

S Afr Med J

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Corresponding author: D J J Muckart (davidmuc@ialch.co.za)Background. Injury in childhood is a major cause of potentially preventable morbidity and mortality. In order to implement effective preventive strategies, epidemiological data on mechanisms of injury and outcome are essential. Objectives. To assess the causation, severity of injury, morbidity and mortality of paediatric trauma admitted to a level 1 trauma intensive care unit (TICU). Methods. Children were defined as being <16 years of age. The study covered the 5-year period January 2008 -December 2012. Eligible patients were identified from a prospective database maintained in the level 1 TICU at Inkosi Albert Luthuli Central Hospital, Durban, South Africa. Data extracted were referral source, mechanism of injury, age and gender distribution, injury severity score (ISS), anatomical distribution of injury and mortality. Results. A total of 181 patients admitted during the study period accounted for 15.9% of all admissions. There were 84 females (46.4%) and 97 males (53.6%), with a median age of 7 years (interquartile range (IQR) 4 -10). Sources of admission were directly from the scene in 38 cases (21.0%), from a primary healthcare facility in 47 (26.0%), from a regional hospital in 56 (31.0%) and from a tertiary facility in 40 (22.0%). Mortality rates according to location of transfer were regional hospital 8 deaths (30.8%), tertiary facility 7 (26.9%), primary health clinic 7 (26.9%), and from the scene 4 (15.4%). Mechanisms of injury were pedestrian-motor vehicle collision (PMVC) in 105 cases (58.0%), motor vehicle passenger in 38 (21.0%), non-vehicular blunt trauma in 18 (10.0%), gunshot wounds (GSWs) in 12 (6.6%), stab wounds in 6 (3.3%), bull goring in 1 (0.5%) and bicycle accident 1 (0.5%). The median ISS for all admissions was 25 . ISSs were >25 in 98 patients (54.1%), 16 -25 in 51 (28.2%), 9 -15 in 9 (4.9%) and <9 in 13 (7.2%); 61.9% of patients had head injuries, 48.1% injuries to the extremities, 41.4% abdominal trauma, 40.3% thoracic trauma, 20.4% external soft-tissue trauma, 9.9% cervical injury and 9.4% facial trauma. There were 26 deaths (14.4%), of which PMVCs accounted for 16 (61.5%), motor vehicle passengers for 7 (26.9%), blunt trauma for 2 (7.7%) and GSWs for 1 (3.8%). The majority of deaths (92%) were of patients with an ISS >25. Of the 26 patients who died, 88.4% had a head injury, 46.2% an extremity injury, 38.5% an external injury, 34.6% abdominal or chest injuries, 19.2% neck injury and 11.5% facial injury. Conclusions. Motor vehicle-related injuries, especially PMVCs, dominate severe paediatric trauma and there is an urgent need for more road traffic education and stringent measures to decrease the incidence and associated morbidity and mortality.

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Physiotherapy in children hospitalized with traumatic brain injury in a South African tertiary paediatric hospital

Corten

Rahim

et al. 2020

Physiotherapy Res Intl

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Introduction: Physical impairments following traumatic brain injury (TBI) may limit participation in daily living. Physiotherapy could assist in managing these limitations, however, there is a paucity of literature on the physiotherapy management of children in the acute phase of TBI. Objectives: To describe the characteristics, course and outcome of children hospitalized with TBI, with specific reference to the role of physiotherapy. Methods: A retrospective folder review of all children (n = 130, median 5.37 years [IQR 1.88-7.88]) admitted in 2016 with a primary diagnosis of TBI was conducted at a tertiary paediatric hospital. Results: Most cases presented with mild TBI (66.2%). The most common cranial manifestation of the TBI was brain bleeds (80%) and most occurred as a result of road traffic accidents (50%, including both pedestrian and motor vehicle accidents). Physiotherapy was administered in 35 cases (26.9%), with functional interventions, such as mobilizations out of bed, the most common form of therapy (71.4%). Children involved in road traffic accidents, presenting with severe diffuse TBI, resulting in altered tone and coordination problems, admitted to intensive care, monitored with an intracranial pressure or Licox monitor, and receiving occupational therapy and/or been followed up by dieticians, were more likely to receive physiotherapy. The duration of hospitalization (median 4 days [IQR 2-9]) was associated with infections, severity of TBI, presence of an intracranial monitoring, and parietal lobe injury. Conclusion: This is the first study in South Africa investigating standard physiotherapy care in children admitted with TBI. Physiotherapy was provided in a small portion of children and appeared to be well tolerated. However, due to the limited information recorded in the physiotherapy notes, results of this study need to be confirmed in larger, more well-documented studies before generalizations can be made.

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Demographic profile of severe traumatic brain injury admissions to Red Cross War Memorial Children’s Hospital, 2006 - 2011

Abstract: The identification of aetiological factors and the description of demographic profiles of children sustaining TBI constitutes a basis for preventative policy administration and intervention strategies in SA.

Cited by 34 publications

References 23 publications

The spectrum and outcome of paediatric traumatic brain injury in KwaZulu-Natal Province, South Africa has not changed over the last two decades

The spectrum and outcome of paediatric traumatic brain injury in KwaZulu-Natal Province, South Africa has not changed over the last two decades

The wrong and wounding road: Paediatric polytrauma admitted to a level 1 trauma intensive care unit over a 5-year period

Physiotherapy in children hospitalized with traumatic brain injury in a South African tertiary paediatric hospital

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