Characteristics and trends of pediatric traumatic brain injuries treated at a large pediatric medical center in China, 2002-2011.

Jianbo Shao,Krista Wheeler,Keith Yeates,Hongyan Yao,Huiping Zhu,Lorann Stallones,Huiyun Xiang

doi:10.1371/journal.pone.0051634

Abstract

BackgroundPediatric traumatic brain injuries (TBIs) have not been well studied in China. This study investigated characteristics and trends of hospitalized TBIs sustained by Chinese children.Methods and FindingsWe analyzed 2002–2011 hospitalized TBI patients (0–17 years of age) treated at a large pediatric medical center in China. TBIs were defined using the International Classification of Diseases, Tenth Revision (ICD-10) codes. We examined age patterns across external causes of TBIs. We reported the trend of traffic-related TBIs for each year from 2002 to 2011. Of 4,230 TBI patients, 67.1% (95% CI: 65.4%–68.8%) were city residents and 28.8% (95% CI: 26.3%–31.3%) came from rural villages. Males had disproportionately more TBIs than females (65.2% vs. 34.8%). Falls, struck by/against objects, and traffic collisions were the top three external causes of TBIs for all age groups. Falls were the leading cause of TBI for all ages but peaked at 2 years of age. There were 125 TBIs in 0–2 year olds (5.9% of all TBIs in this age group) that were caused by suspected child abuse. Suspected child abuse was significantly more likely to occur in 0–1 year olds. The proportion of traffic -related TBIs increased significantly from 12.99% in 2002 to 19.68% in 2008 but dropped each subsequent year until it reached a level of 8.91% in 2011.ConclusionsOur study confirms that falls, struck by/against objects and traffic collisions are the top external causes of TBIs in Chinese children. When compared with national data from the developed countries, gender patterns are similar, but the ranking of external causes is different. This is the first study to highlight the important role of suspected child abuse in causing TBIs in infants in China. TBIs caused by child abuse warrant further research and government attention as a social and medical problem in China.

Highlights

When compared with national data from the developed countries, gender patterns are similar, but the ranking of external causes is different. This is the first study to highlight the important role of suspected child abuse in causing traumatic brain injuries (TBIs) in infants in China
TBIs caused by child abuse warrant further research and government attention as a social and medical problem in China
We studied the distribution of ages of pediatric TBIs caused by road traffic collisions, falls, and assault/child abuse

Summary

Introduction

Traumatic brain injury (TBI) is a leading cause of death and long-term disabilities around the world. [1] Previous studies indicate that TBIs can have a significant negative impact on the lives of the injured and their family members and inflict a huge economic burden on healthcare systems. [2,3,4,5,6,7,8,9,10] For these reasons, many countries have developed surveillance systems to measure the impact of TBIs and have conducted epidemiologic studies to identify risk factors and patterns of TBI to guide and evaluate effective prevention programs. [10,11,12,13,14,15]. Traumatic brain injury (TBI) is a leading cause of death and long-term disabilities around the world. [1] Previous studies indicate that TBIs can have a significant negative impact on the lives of the injured and their family members and inflict a huge economic burden on healthcare systems. [2,3,4,5,6,7,8,9,10] For these reasons, many countries have developed surveillance systems to measure the impact of TBIs and have conducted epidemiologic studies to identify risk factors and patterns of TBI to guide and evaluate effective prevention programs. Pediatric traumatic brain injuries (TBIs) have not been well studied in China. This study investigated characteristics and trends of hospitalized TBIs sustained by Chinese children

Methods

Results

Discussion

Conclusion