Kam Lun Hon1, Siwei Huang2, Wai Sang Poon3, Hon Ming Cheung1, Patrick Ip4, Benny Zee2. 1. Department of Pediatrics, The Chinese University of Hong Kong, Hong Kong. 2. The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong. 3. Division of Neurosurgery, Department of Surgery, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong. 4. Department of Pediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong.
Abstract
OBJECTIVE: To determine the mortality, morbidity, types of intracranial hemorrhages, and factors associated with length of stay (LOS) associated with accidental traumatic brain injury (TBI) at a pediatric intensive care unit (PICU) of a regional trauma center in an Asian city. METHODS: This study is a retrospective review of types of head injury, mortality and morbidity demographics of patients admitted to a PICU with TBI. All patients with accidental TBI were included, namely road traffic injury (RTI) and fall, and their demographics compared. Non-accidental injuries (NAI) were excluded. RESULTS: 95 children (78% males) were admitted to a PICU with RTI or falls from 2002 to 2017. They accounted for 3.7% of PICU admissions. Comparing with falls, victims of RTI were older (p<0.001) and more likely to suffer from skull fracture (p=0.017). There were 4 deaths with falls (6.8%) but none with RTI. Subarachnoid hemorrhages, extradural hemorrhages, the use of mechanical ventilation, inotropes and neurological supports were associated with longer LOS in PICU in these injuries (p<0.001). CONCLUSION: A longer PICU LOS is associated with extradural and subarachnoid hemorrhages, usage of inotropes, mechanical ventilation and neurological supports in falls and RTI. Three-quarters of victims are males. Preventive health education should be especially directed to boys to reduce severe TBI in this Asian city.
OBJECTIVE: To determine the mortality, morbidity, types of intracranial hemorrhages, and factors associated with length of stay (LOS) associated with accidental traumatic brain injury (TBI) at a pediatric intensive care unit (PICU) of a regional trauma center in an Asian city. METHODS: This study is a retrospective review of types of head injury, mortality and morbidity demographics of patients admitted to a PICU with TBI. All patients with accidental TBI were included, namely road traffic injury (RTI) and fall, and their demographics compared. Non-accidental injuries (NAI) were excluded. RESULTS: 95 children (78% males) were admitted to a PICU with RTI or falls from 2002 to 2017. They accounted for 3.7% of PICU admissions. Comparing with falls, victims of RTI were older (p<0.001) and more likely to suffer from skull fracture (p=0.017). There were 4 deaths with falls (6.8%) but none with RTI. Subarachnoid hemorrhages, extradural hemorrhages, the use of mechanical ventilation, inotropes and neurological supports were associated with longer LOS in PICU in these injuries (p<0.001). CONCLUSION: A longer PICU LOS is associated with extradural and subarachnoid hemorrhages, usage of inotropes, mechanical ventilation and neurological supports in falls and RTI. Three-quarters of victims are males. Preventive health education should be especially directed to boys to reduce severe TBI in this Asian city.
Authors: Gordon D Murray; Isabella Butcher; Gillian S McHugh; Juan Lu; Nino A Mushkudiani; Andrew I R Maas; Anthony Marmarou; Ewout W Steyerberg Journal: J Neurotrauma Date: 2007-02 Impact factor: 5.269
Authors: Jason E Frankel; Jennifer H Marwitz; David X Cifu; Jeffrey S Kreutzer; Jeffrey Englander; Mitchell Rosenthal Journal: Arch Phys Med Rehabil Date: 2006-01 Impact factor: 3.966