Pediatric Inpatient Humanitarian Care in Combat: Iraq and Afghanistan 2002 to 2012

Severe Pediatric Head Injury During the Iraq and Afghanistan Conflicts

“…The majority (76%) of children treated were male with a median age of 8 years (range 0. [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17]. Penetrating injuries were the most common type (60.6%), with the most common causes being IED (37.9%) or blast (25%).…”

“…For descriptive purposes, patients in the entire cohort were further divided into the following age groups: infant (0-1 year), toddler (2-3), child (4-9), preteen (10)(11)(12), and adolescent (13)(14)(15)(16)(17). Data from the JTTR classified injury types into open, penetrating, and closed categories.…”

“…Second, blunt head injuries are often associated with other organ system injuries, which we excluded. 8 [5][6][7][8][9][10][11][12] .94 8 [5][6][7][8][9][10][11][12] 8 [5][6][7][8][9][10][11][12] .49 8 [5][6][7][8][9][10][11] 8 [5][6][7][8][9][10][11][12] . .46…”

“…There was a statistical trend, suggesting that a closed head injury was also an independent predictor of survival (P = .07), which would not be unexpected, but did not reach significance because of the small number of patients we had with this type of injury. Many others have used the JTTR for research [32][33][34] with inhospital mortality 10,13,24,32,33,35 as the primary outcome; however, the JTTR has significant limitations, as detailed by others. 36 The JTTR was designed to capture demographic and outcome data for process improvement, such as the development of clinical practice guidelines.…”

“…Many authors have documented their experience treating children injured during these campaigns. 1,[6][7][8][9][10][11][12][13][14] We and others have detailed our experience treating children with neurosurgical injuries and diseases during these 2 conflicts, typically over a finite time period. [15][16][17] This project was undertaken to describe the epidemiologic features and outcomes associated with isolated severe head injury in children treated at military medical facilities during OIF and OEF with the use of the Joint Theater Trauma Registry (JTTR).…”