Abstract
Objective: To use the 2006–2013 Nationwide Emergency Department Sample (NEDS) database to describe trends of age-adjusted rates of pediatric traumatic brain injuries (TBI) treated in U.S. emergency departments. Methods: Time trend analysis was conducted on age-adjusted rates among children ≤17 years in the U.S. The annual percent change (APC) was calculated by fitting a least squares regression to the logarithm of the rates, using the calendar year as an independent variable. Results: In males, motor-vehicle-related trauma (APC −2.5%) and severe TBI (APC −3.6%) decreased over the study time period. Conversely, concussion (APC 5.1%), unspecified head injury (APC 6.6%), fall-related TBI (APC 7.1%), and mild TBI (APC 5.9%) increased. In females, severe TBI (APC −3.3%) decreased over the study time period and concussion (APC 6.5%), unspecified head injury (APC 7.2%), fall-related TBI (APC 7.6%), and mild TBI (APC 6.8%) increased. Conclusion: The overall age-adjusted rates of pediatric TBI-related emergency department (ED) visits increased from 2006 to 2013, which is largely caused by pediatric mild TBIs, especially unspecified injury to the head (ICD-9-CM code 959.01) and concussion. In comparison, age-adjusted rates of pediatric severe TBIs decreased. A major contributing factor might be a reduced number of traffic-related head trauma.
Highlights
Traumatic brain injury (TBI) is the leading cause of death and disability among children and adolescents in the U.S [1] Each year, an estimated 50,000–60,000 U.S children are hospitalized for TBI, at a rate of 70–75 cases per 100,000 children [2,3]
When comparing incidences from different years, we need to consider the variation of the population composition, so it is necessary to standardize the population composition for different years before analyzing the trend. Understanding these issues will provide important evidence about the trend of pediatric traumatic brain injuries, and help guide future interventions in the U.S This study investigates the epidemiological trends for pediatric TBI-related emergency department (ED) visits in the U.S using statistical methods to account for these two issues
ED visits by age and the age-adjusted rates of pediatric TBI related ED visits by sex (Table 1 and Figure 1)
Summary
Traumatic brain injury (TBI) is the leading cause of death and disability among children and adolescents in the U.S [1] Each year, an estimated 50,000–60,000 U.S children are hospitalized for TBI, at a rate of 70–75 cases per 100,000 children [2,3]. Since the mid-1990s, laws, such as the Public Law 104–166 [6], the TBI Act Amendments of 2000 [7], and the TBI Act of 2008 [8], have guided federal agencies, researchers, and TBI prevention programs to develop and strengthen existing surveillance systems and prevention efforts to address the public health impact of TBIs. In 2008, the U.S Congress authorized federal agencies, such as the Centers for Disease Control and Prevention (CDC), to engage in activities to decrease the severity and incidence of TBI [9]. Public Health 2018, 15, 1171; doi:10.3390/ijerph15061171 www.mdpi.com/journal/ijerph
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