Pattern and Outcome of TBI in Children: An Observational Study at the Children Hospital Lahore
Objective: TBI is one of the leading causes of mortality. To prevent these deaths and injuries epidemiological evidence is required in individual areas. The study aims to understand the common causes of TBI in children in a localized area of Pakistan.
Material and Methods: This is a descriptive study that enrolled 720 children with head injuries aged 0 to 14 years from September 2021 to June 2022 at UCHS/CHL. Demographic variables like age and gender were noted. Moreover, presenting features of the wound/injury, the cause behind the injury, the severity of the wound, as well as operative procedures that were undertaken, were all recorded.
Results: Mean age of the children was 5 years. Most of them were boys (69.25%). Many of the head injuries were caused due to falls (78.94%) followed by RTA (20.7%). 62.32% of the patients arrived via ambulance. The mortality rate among severe head injury was 65.09%, moderate head injury was 26.31% and mild head injury was 8.52%. It was observed favorable outcomes were noted in patients who presented to the hospital within four hours of injury. (The p-value is .0026).Conclusion: Head injuries among children in Pakistan are primarily due to falls and road accidents. There is a need for betterment in the architecture of housing and road traffic management to prevent TBI-related mortalities. Awareness and logistics need to be provided for the quick transfer of patients with trauma to neurosurgical emergencies.
Bedry T, Tadele H. Pattern and Outcome of Pediatric Traumatic Brain Injury at Hawassa University Comprehensive Specialized Hospital, Southern Ethiopia: Observational Cross-Sectional Study. Emerg Med Int. 2020; 2020: 1–9.
Li Q, Alonge O, Lawhorn C, Ambaw Y, Kumar S, Jacobs T, et al. Child injuries in Ethiopia: A review of the current situation with projections. PLoS One, 2018; 13: e0194692.
Dewan MC, Mummareddy N, Wellons JC, Bonfield CM. Epidemiology of Global Pediatric Traumatic Brain Injury: Qualitative Review. World Neurosurg. 2016; 91: 497-509.e1.
Hawley CA, Ward AB, Long J, Owen DW, Magnay AR. Prevalence of traumatic brain injury amongst children admitted to hospital in one health district: A population-based study. Injury, 2003; 34: 256–60.
Bruns J, Hauser WA. The Epidemiology of Traumatic Brain Injury: A Review. Epilepsia, 2003; 44: 2–10.
Bashford T, John Clarkson P, Menon DK, Hutchinson PJA. Unpicking the Gordian knot: a systems approach to traumatic brain injury care in low-income and middle-income countries. BMJ Glob Heal. 2018; 3: e000768.
Wang H, Naghavi M, Allen C, Barber RM, Carter A, Casey DC, et al. Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980–2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet, 2016; 388: 1459–544.
Bahloul M, Chelly H, Chaari A, Chabchoub I, Haddar S, Herguefi L, et al. Isolated traumatic head injury in children: Analysis of 276 observations. J Emergencies, Trauma Shock, 2011; 4: 29.
Bahloul M, Chaari A, Chabchoub I, Medhyoub F, Dammak H, Kallel H, et al. Outcome analysis and outcome predictors of traumatic head injury in childhood: Analysis of 454 observations. J Emergencies, Trauma Shock, 2011; 4: 198.
Punchak M, Abdelgadir J, Obiga O, Itait M, Najjuma JN, Haglund MM, et al. Mechanism of Pediatric Traumatic Brain Injury in Southwestern Uganda: A Prospective Cohort of 100 Patients. World Neurosurg. 2018; 114: e396–402.
Nnadi MON, Bankole O, Fente B. Epidemiology
and treatment outcome of head injury in children: A prospective study. J Pediatr Neurosci. 2014; 9: 237.
Satapathy MC, Dash D, Mishra SS, Tripathy SR, Nath PC, Jena SP. Spectrum and outcome of traumatic brain injury in children <15 years: A tertiary level experience in India. Int J Crit Illn Inj Sci. 2016; 6: 16.
Emejulu JK., Shokunbi M. Aetiological Patterns and Management Outcome of Paediatric Head Trauma: One-year Prospective Study. Niger J Clin Pract. 2010: 13.
Udoh DO, Adeyemo AA. Traumatic brain injuries in children: A hospital-based study in Nigeria. African J Paediatr Surg. 2013; 10: 154.
Razzak JA, Hyder AA, Akhtar T, Khan M, Khan UR. Assessing emergency medical care in low income countries: A pilot study from Pakistan. BMC Emerg Med. 2008; 8: 1–8.
Jeong HW, Choi SW, Youm JY, Lim JW, Kwon HJ, Song SH. Mortality and Epidemiology in 256 Cases of Pediatric Traumatic Brain Injury: Korean Neuro-Trauma Data Bank System (KNTDBS) 2010–2014. J Korean Neurosurg Soc. 2017; 60: 710.
A A, CS A, A K, O L, G M, R K, et al. Epidemiology and management of paediatric head injury in eastern Nepal. Afr J Paediatr Surg. 2008; 5: 15.
Sathian B, Sreedharan J, Baboo SN, Sharan K, Abhilash ES, Rajesh E. Relevance of Sample Size Determination in Medical Research. Nepal J Epidemiol. 2010; 1: 4–10.
Styrke J, Stålnacke BM, Sojka P, Björnstig U. Traumatic brain injuries in a well-defined population: epidemiological aspects and severity. J Neurotrauma, 2007; 24: 1425–36.
Siraj M, Haq MU, Malik NA, Aziz A, Saeed R. Head Injury in Paediatric Age Group: 191. J Surg. Pakistan 2010: 15.
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