Hospitalization and Morbidity Rates After Pediatric Traumatic Brain Injury: A Nation-Wide Population-Based Analysis.

Nora Bruns,Ursula Felderhoff-Müser,Andreas Stang,Pietro Trocchi,Christian Dohna-Schwake

doi:10.3389/fped.2021.747743

Nora Bruns, Ursula Felderhoff-Müser + Show 3 more

Open Access

https://doi.org/10.3389/fped.2021.747743

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Abstract

Background: Even though traumatic brain injury (TBI) is a major cause of morbidity and mortality in children around the globe, population-based and nation-wide data to assess the burden of TBI is scarce.Methods:Based on diagnosis related groups from nation-wide hospital data, we extracted data on all TBI-related hospitalizations in children <18 years in Germany between 2014 and 2018. We calculated crude, age-specific and standardized incidence rates for hospitalizations, imaging, intracranial injury, neurosurgery, and mortality.Results:Out of 10.2 million hospitalizations, we identified 458,844 cases with TBI as primary or secondary diagnosis, resulting in a crude incidence rate of 687/100,000 child years (CY). Age-specific rates of computed tomography were below 30/100,000 CY until the age of 10 years and increased to 162/100,000 CY until 17 years of age. Intracranial injury was diagnosed in 2.7%, neurosurgery was performed in 0.7% of patients, and 0.7% were mechanically ventilated. Mortality was 0.67/100,000 CY (0.1%).Conclusions:Despite substantial hospitalization rates for pediatric TBI in Germany, the rates of imaging, the need for mechanical ventilation, neurosurgery and mortality were overall very low. Reasons for hospitalization and measures to reduce unnecessary admissions warrant further investigation.

Highlights

Traumatic brain injury frequently occurs in children and represents a relevant cause of pediatric morbidity and mortality worldwide [1, 2]
Out of 10,244,649 million hospitalizations < 18 years of age, we identified 458,844 cases with traumatic brain injury (TBI) as primary or secondary diagnosis
TBI was the primary diagnosis in 418,603 cases (91.2%, crude incidence rate 687/100,000 child years) (Table 1)

Summary

Introduction

Traumatic brain injury frequently occurs in children and represents a relevant cause of pediatric morbidity and mortality worldwide [1, 2]. Incidence rates vary considerably between studies and countries, especially with respect to hospitalization and imaging practices [1]. In the United States of America (US), annual incidence rates of TBI have been estimated to be 799/100,000 children [3]. Crude annual US hospitalization rates declined from 119/100,000 children below 18 years to ∼73/100,000 between the 1990s and 2005 [4]. Even though traumatic brain injury (TBI) is a major cause of morbidity and mortality in children around the globe, population-based and nation-wide data to assess the burden of TBI is scarce

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