Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia · 2026
Epidemiology, management, and outcomes of pediatric traumatic brain injury: a prospective study from a tertiary trauma centre in North India.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Khanal Saroj, Tripathi Manjul, Vyas Sameer, Kishore Kamal, Punukollu Anuraag, Batish Aman, Mohindra Sandeep, Chauhan Rajeev
Аннотация
INTRODUCTION AND OBJECTIVE: Pediatric traumatic brain injury (TBI) is the leading cause of trauma-related mortality and disability in children, with patterns of injury and outcomes differing significantly from adults. We analysed epidemiological factors, management, and outcomes of pediatric TBI at a tertiary trauma centre in North India.
MATERIALS AND METHODS: This prospective observational study (June 2022 to May 2023) included children ≤12 years presenting with head injury. Demographic data, injury mechanism, clinical and radiological findings, management, and outcomes were recorded. Statistical analysis was performed using SPSS v22, with p < 0.05 considered significant.
RESULTS: A total of 244 children with head injury were included (mean age 5.04 years; M:F = 1.39:1). Falls were the predominant mechanism (75.8%), followed by road traffic accidents (19.7%). Most children (83.7%) reached the hospital within 24 h of injury (mean time 17.06 ± 27.66 h). Vomiting (61.9%) and loss of consciousness (LOC) (46.3%) were most common presenting symptoms. Injuries were mild in 71.7% and severe in 15.6%. Isolated head injury was seen in 87.3%; associated injuries occurred in 12.7%, most commonly extremity fractures (8.6%). NCCT findings included scalp hematoma (64.8%), linear skull fracture (40.6%), hemorrhagic contusion (29.1%), and normal scans in 12.7%. Non-operative management was employed in 87.7%; 22.1% required mechanical ventilation and 17.6% required intensive care. Overall mortality was 6.14%. At discharge, 84.8% had good recovery and 9.4% disability, which improved to 7.8% at 3 months. Mean hospital stay was 5.56 days. On multivariable logistic regression, severe TBI and prolonged loss of consciousness (>5 min) were independently associated with poor outcome at discharge.
CONCLUSION: Pediatric TBI in this cohort was associated with a high rate of favorable outcomes, particularly among children with mild injuries. Injury severity and early neurological impairment remain the strongest predictors of outcome. Given the predominance of fall-related injuries occurring in domestic settings, targeted injury-prevention strategies and improved child safety measures have the potential to substantially reduce the burden of pediatric TBI.
MATERIALS AND METHODS: This prospective observational study (June 2022 to May 2023) included children ≤12 years presenting with head injury. Demographic data, injury mechanism, clinical and radiological findings, management, and outcomes were recorded. Statistical analysis was performed using SPSS v22, with p < 0.05 considered significant.
RESULTS: A total of 244 children with head injury were included (mean age 5.04 years; M:F = 1.39:1). Falls were the predominant mechanism (75.8%), followed by road traffic accidents (19.7%). Most children (83.7%) reached the hospital within 24 h of injury (mean time 17.06 ± 27.66 h). Vomiting (61.9%) and loss of consciousness (LOC) (46.3%) were most common presenting symptoms. Injuries were mild in 71.7% and severe in 15.6%. Isolated head injury was seen in 87.3%; associated injuries occurred in 12.7%, most commonly extremity fractures (8.6%). NCCT findings included scalp hematoma (64.8%), linear skull fracture (40.6%), hemorrhagic contusion (29.1%), and normal scans in 12.7%. Non-operative management was employed in 87.7%; 22.1% required mechanical ventilation and 17.6% required intensive care. Overall mortality was 6.14%. At discharge, 84.8% had good recovery and 9.4% disability, which improved to 7.8% at 3 months. Mean hospital stay was 5.56 days. On multivariable logistic regression, severe TBI and prolonged loss of consciousness (>5 min) were independently associated with poor outcome at discharge.
CONCLUSION: Pediatric TBI in this cohort was associated with a high rate of favorable outcomes, particularly among children with mild injuries. Injury severity and early neurological impairment remain the strongest predictors of outcome. Given the predominance of fall-related injuries occurring in domestic settings, targeted injury-prevention strategies and improved child safety measures have the potential to substantially reduce the burden of pediatric TBI.