# Clinical Characteristics and Outcomes of Pediatric Traumatic Brain Injury Patients in a Tertiary Regional Trauma Center in the Philippines

## TL;DR

This study examines the clinical features and outcomes of children with traumatic brain injuries in a Philippine hospital, finding that most injuries are mild but severe cases have high mortality.

## Contribution

The study provides new insights into pediatric TBI in the Philippines, a region with limited data on this topic.

## Key findings

- Most pediatric TBI cases were mild, with motor vehicle crashes being the primary cause in older children.
- Severe TBI cases had a high mortality rate (30.8%), and epidural hematoma was the most common abnormal finding.
- Complication rates were relatively low, but neurological deficits were common among surgically treated patients.

## Abstract

Traumatic brain injury (TBI) is a leading cause of disability and death in children. Limited data exists on pediatric TBI in Southeast Asia, especially in low- and –middle-income countries. This study investigates the clinical characteristics and outcomes of pediatric TBI patients in a tertiary trauma center in the Philippines. This retrospective cohort study examined pediatric patients (18 years and under) with TBI admitted to a Philippine trauma center from 2021 to 2023. A total of 218 patients were included. Data on demographics, injury mechanisms, TBI severity, cranial imaging, surgical procedures, complications, and discharge outcomes were analyzed.

Among the 218 patients, 75% were male, and most were aged 13–18. The primary mechanism of injury was motor vehicle crashes (MVCs), especially in older children (80%). For patients under 5, falls and MVCs were equally common. Most cases were mild (69%), and 40.8% had negative cranial imaging. Epidural hematoma (20%) was the most common abnormal finding. Of the patients, 8% required surgery, with craniotomy for epidural hematoma being the most frequent procedure. Half of those who underwent surgery had neurological deficits, and there was one recorded death. Overall, 86.7% of patients were discharged without complications, though only 34.6% of those with severe TBI had good outcomes. The overall complication rate was 8.7%, with mild neurological deficits being most common. The case fatality rate was 4.6%, with severe TBI showing a higher rate of 30.8%. The majority of patients were male teenagers involved in MVCs. Although most TBIs were mild, there was a notable incidence of severe TBI, particularly with epidural hematoma. These findings suggest higher-impact trauma in the Philippines. The complication and mortality rates align with other studies. Efforts should focus on road safety, traffic law enforcement, and public education. A multi-center prospective study is needed to better understand the factors influencing outcomes in pediatric TBI.