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Characteristics, image findings and clinical outcome of moderate and severe traumatic brain injury among severely injured children: a population-based cohort study

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European Journal of Trauma and Emergency Surgery Aims and scope Submit manuscript

Abstract

Purpose

The aim of this study was to explore patient and injury characteristics, image findings, short-term clinical outcome and time trends of moderate and severe traumatic brain injury in severely injured children.

Methods

This study is an observational cohort study based on prospectively collected data from an institutional trauma registry database covering all trauma patients in South West Norway. All paediatric patients registered in the database between 01.01.2004 and 31.12.2019 were included.

Results

During the 16 years-study periods, 82 paediatric patients with moderate (n = 42) and severe (n = 40) traumatic brain injury were identified. Median age was 13.0 years, 45% were female and median Glasgow Coma Scale score at admission was 9.0. Cranial fractures were common image findings in both groups. Cerebral contusions (32%) and epidural hematomas (29%) were more commonly found in moderate traumatic brain injury; cerebral contusions (49%), diffuse axonal injury (31%) and cerebral oedema (46%) were more prominent in severe traumatic brain injury. All children with moderate traumatic brain injury survived and favourable outcome was registered in 98%. Overall mortality in the severe traumatic brain injury cohort was 38% (thereof 25% due to TBI) and only 38% had a favourable short-term outcome.

Conclusions

In this population-based study on paediatric trauma patients over a period of 16 years severe traumatic brain injury in children still had a considerably high mortality and a higher proportion of patients experienced an unfavourable clinical short-term outcome. Moderate traumatic brain injury resulted in favourable clinical outcome.

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Funding

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Author information

Authors and Affiliations

  1. Department of Neurosurgery, Stavanger University Hospital, Postboks 8100, 4068, Stavanger, Norway

    Clemens Weber & Maziar Behbahani

  2. Department of Quality and Health Technology, The Faculty of Health Sciences, University of Stavanger, Stavanger, Norway

    Clemens Weber

  3. Department of Gastrointestinal Surgery, Stavanger University Hospital, Stavanger, Norway

    Joakim Stray Andreassen, Kenneth Thorsen & Kjetil Søreide

  4. Department of Clinical Medicine, The Faculty of Medicine, University of Bergen, Bergen, Norway

    Kenneth Thorsen & Kjetil Søreide

  5. Section for Traumatology, Surgical Clinic, Stavanger University Hospital, Stavanger, Norway

    Kenneth Thorsen

Authors
  1. Clemens Weber
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  2. Joakim Stray Andreassen
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  3. Maziar Behbahani
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  4. Kenneth Thorsen
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  5. Kjetil Søreide
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Corresponding author

Correspondence to Clemens Weber.

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Conflict of interest

The authors report no conflicts of interest or competing interests related to the research presented in this manuscript.

Ethical approval

The Regional Committee for Medical and Health Research Ethics of Western Norway approved this observational, registry-based study (ID: 143902). All patients and/or their legal guardians received written and oral information about the registry and its purpose.

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Weber, C., Andreassen, J.S., Behbahani, M. et al. Characteristics, image findings and clinical outcome of moderate and severe traumatic brain injury among severely injured children: a population-based cohort study. Eur J Trauma Emerg Surg 48, 4473–4480 (2022). https://doi.org/10.1007/s00068-021-01820-y

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  • DOI: https://doi.org/10.1007/s00068-021-01820-y

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