Pediatric moderate and severe traumatic brain injury – A national, population-based cohort study

TL;DR

This study examines the causes and outcomes of moderate and severe traumatic brain injuries in children using national data, finding a low mortality rate and better recovery in most cases.

Contribution

The study provides population-based insights into pediatric TBI mechanisms and outcomes in Norway over four years.

Findings

High-energy falls and road traffic accidents were the most common injury mechanisms.

Severe TBI had a significantly higher 30-day mortality rate (12%) compared to moderate TBI (1%).

Most patients (4 out of 5) had good outcomes with moderate, low, or no disability.

Abstract

This study aims to investigate the epidemiological characteristics, injury mechanisms, and clinical outcomes of children with moderate and severe traumatic brain injury (TBI), using population-based data from a national trauma registry.

This nationwide observational cohort study includes all pediatric patients (0–17 years) with moderate and severe TBI registered in the Norwegian Trauma Registry between January 1, 2017, and December 31, 2020.

A total of 348 pediatric patients with moderate (n = 289, 83%) and severe n = 59, 17%) TBI were analyzed. The most common injury mechanism were high-energy falls (33%) and road traffic accidents (29%). The 30-day mortality rate was 3%, significantly higher in severe TBI (12%) than moderate TBI (1%, p < 0,001). Patients with severe TBI had longer hospital stays and poorer functional recovery than those with moderate TBI.

This population-based study on pediatric TBI patients over a period of 4 years revealed a relatively low mortality rate. In 4 out of 5 patients moderate or severe TBI resulted in a good outcome with moderate, low or no disability. Advancing the understanding of evidence-based interventions aiming at preventing both primary and secondary injuries associated with pediatric TBI is essential for optimizing recovery and promoting functional independence in these young patients.

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