Injury Causes and Severity in Pediatric Traumatic Brain Injury Patients Admitted to the Ward or Intensive Care Unit: A Collaborative European Neurotrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) Study

Riemann, Lennart; Zweckberger, Klaus; Unterberg, Andreas; Damaty, Ahmed El; Younsi, Alexander; Participants,

doi:10.3389/fneur.2020.00345

Cited by 18 publications

(18 citation statements)

References 32 publications

(54 reference statements)

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“…This approximately corroborates with a study in UK major trauma center with 9.0% reported case fatality [ 5 ]. The estimated case fatality rate is higher than those reported in Europe [ 33 ], India [ 34 ], Australia [ 35 ] and United States [ 36 ], which reported 3.0%, 3.0% 0.87% and 4.5% respectively. However, our estimate is lower than the 22.8% reported in the US trauma registry [ 37 ].…”

Section: Discussionmentioning

confidence: 59%

Estimated incidence and case fatality rate of traumatic brain injury among children (0–18 years) in Sub-Saharan Africa. A systematic review and meta-analysis

2021

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Introduction Studies from Sub-Saharan Africa (SSA) countries have reported on the incidence and case fatality rate of children with Traumatic Brain Injury (TBI). However, there is lack of a general epidemiologic description of the phenomenon in this sub-region underpinning the need for an accurate and reliable estimate of incidence and outcome of children (0–18 years) with TBI. This study therefore, extensively reviewed data to reliably estimate incidence, case fatality rate of children with TBI and its mechanism of injury in SSA. Methods Electronic databases were systematically searched in English via Medline (PubMed), Google Scholar, and Africa Journal Online (AJOL). Two independent authors performed an initial screening of studies based on the details found in their titles and abstracts. Studies were assessed for quality/risk of bias using the modified Newcastle-Ottawa Scale (NOS). The pooled case fatality rate and incidence were estimated using DerSimonian and Laird random-effects model (REM). A sub-group and sensitivity analyses were performed. Publication bias was checked by the funnel plot and Egger’s test. Furthermore, trim and fill analysis was used to adjust for publication bias using Duval and Tweedie’s method. Results Thirteen (13) hospital-based articles involving a total of 40685 participants met the inclusion criteria. The pooled case fatality rate for all the included studies in SSA was 8.0%; [95% CI: 3.0%-13.0%], and the approximate case fatality rate was adjusted to 8.2%, [95% CI:3.4%-13.0%], after the trim-and-fill analysis was used to correct for publication bias. A sub-group analysis of sub-region revealed that case fatality rate was 8% [95% CI: 2.0%-13.0%] in East Africa, 1.0% [95% CI: 0.1% -3.0%] in Southern Africa and 18.0% [95% CI: 6.0%-29.0%] in west Africa. The pooled incidence proportion of TBI was 18% [95% CI: 2.0%-33.0%]. The current review showed that Road Traffic Accident (RTA) was the predominant cause of children’s TBI in SSA. It ranged from 19.1% in South Africa to 79.1% in Togo. Conclusion TBI affects 18% of children aged 0 to 18 years, with almost one-tenth dying in SSA. The most common causes of TBI among this population in SSA were RTA and falls. TBI incidence and case fatality rate of people aged 0–18 years could be significantly reduced if novel policies focusing on reducing RTA and falls are introduced and implemented in SSA.

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Section: Discussionmentioning

confidence: 59%

Estimated incidence and case fatality rate of traumatic brain injury among children (0–18 years) in Sub-Saharan Africa. A systematic review and meta-analysis

2021

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“…In contrast, in London, only 1% of moderate and severe paediatric TBI was found in cyclists who were hit by a car or fell of the bicycle, as opposed to the 39% of patients who were hit by a car as a pedestrian (2). Another European childhood TBI study found that only 25% of RTA victims were cyclists (9). These outcomes suggest there are several possibilities for prevention of moderate and severe TBI.…”

Section: Discussionmentioning

confidence: 96%

“…The last Dutch epidemiological study describes the incidence over 10 years ago (4). In keeping with adult studies, most paediatric studies reveal falls and RTAs as the most frequent mechanism of injury (9). However, children are passengers rather than drivers when it comes to motor vehicles and are more often involved as a pedestrian (9).…”

Section: Introductionmentioning

confidence: 93%

“…In keeping with adult studies, most paediatric studies reveal falls and RTAs as the most frequent mechanism of injury (9). However, children are passengers rather than drivers when it comes to motor vehicles and are more often involved as a pedestrian (9). Furthermore, in high income countries, the incidence of road traffic accidents seem to have decreased over the last decades due to preventative measures (10).…”

Section: Introductionmentioning

confidence: 97%

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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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“…This practice creates a significant burden on pediatric IC units; about half of children with mTBI, admitted to an ICU have GCS 15. 54 There are five predictor variables to identify children requiring ICU-level care: GCS <15, non-isolated head injury, and on CT a midline shift >5 mm, absent cisterns, or intraventricular hemorrhage. 47,55 Implementing these predictors leads to ICU-admission rates of 66 to 81% in this group.…”

Section: Neurosurgical Interventionmentioning

confidence: 99%

A Child Presenting with a Glasgow Coma Scale Score of 13: Mild or Moderate Traumatic Brain Injury? A Narrative Review

Hageman

Nihom

2021

Neuropediatrics

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Objective The objective of this article was to compare children with traumatic brain injury (TBI) and Glasgow Coma Scale score (GCS) 13 with children presenting with GCS 14 and 15 and GCS 9 to 12. Data Source We searched PubMed for clinical studies of children of 0 to 18 years of age with mild TBI (mTBI) and moderate TBI, published in English language in the period of 2000 to 2020. Study Selection We selected studies sub-classifying children with GCS 13 in comparison with GCS 14 and 15 and 9 to 12. We excluded reviews, meta-analyses, non-U.S./European population studies, studies of abusive head trauma, and severe TBI. Data Synthesis Most children (>85%) with an mTBI present at the emergency department with an initial GCS 15. A minority of only 5% present with GCS 13, 40% of which sustain a high-energy trauma. Compared with GCS 15, they present with a longer duration of unconsciousness and of post-traumatic amnesia. More often head computerized tomography scans show abnormalities (in 9–16%), leading to neurosurgical intervention in 3 to 8%. Also, higher rates of severe extracranial injury are reported. Admission is indicated in more than 90%, with a median length of hospitalization of more than 4 days and 28% requiring intensive care unit level care. These data are more consistent with children with GCS 9 to 12. In children with GCS 15, all these numbers are much lower. Conclusion We advocate classifying children with GCS 13 as moderate TBI and treat them accordingly.

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Injury Causes and Severity in Pediatric Traumatic Brain Injury Patients Admitted to the Ward or Intensive Care Unit: A Collaborative European Neurotrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) Study

Cited by 18 publications

References 32 publications

Estimated incidence and case fatality rate of traumatic brain injury among children (0–18 years) in Sub-Saharan Africa. A systematic review and meta-analysis

Estimated incidence and case fatality rate of traumatic brain injury among children (0–18 years) in Sub-Saharan Africa. A systematic review and meta-analysis

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

A Child Presenting with a Glasgow Coma Scale Score of 13: Mild or Moderate Traumatic Brain Injury? A Narrative Review

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