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

Ali Al Mukhtar, Henrik Bergenfeldt, Marcus Edelhamre, Tomas Vedin, Per Anders Larsson, Stefan Öberg

Research output: Contribution to journalArticlepeer-review

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 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.

Original languageEnglish
Article number67
JournalScandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Volume30
Issue number1
DOIs
Publication statusPublished - 2022

Subject classification (UKÄ)

  • Anesthesiology and Intensive Care
  • Pediatrics

Free keywords

  • Computed tomography
  • Isolated head trauma
  • Multitrauma
  • Pediatric traumatic brain injury

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