The prognostic value of injury severity, location of event, and age at injury in pediatric traumatic head injuries

Abstract

Aims

To estimate the prognostic value of injury severity, location of event, and demographic parameters, for symptoms of pediatric traumatic head injury (THI) 4 years later.

Methods

Data were collected prospectively from Reykjavik City Hospital on all patients age 0–19 years, diagnosed with THI (n = 408) during one year. Information was collected on patient demographics, location of traumatic event, cause of injury, injury severity, and ICD-9 diagnosis. Injury severity was estimated according to the Head Injury Severity Scale (HISS). Four years post-injury, a questionnaire on late symptoms attributed to the THI was sent.

Results

Symptoms reported were more common among patients with moderate/severe THI than among others (p < 0.001). The event location had prognostic value (p < 0.05). Overall, 72% of patients with moderate/severe motor vehicle-related THI reported symptoms. There was a curvilinear age effect (p < 0.05). Symptoms were least frequent in the youngest age group, 0–4 years, and most frequent in the age group 5–14 years. Gender and urban/rural residence were not significantly related to symptoms.

Conclusions

Motor vehicle related moderate/severe THI resulted in a high rate of late symptoms. Location had a prognostic value. Patients with motor vehicle-related THI need special consideration regardless of injury severity.

Keywords:

• follow-up
• pediatric
• symptoms
• traumatic head injury

Acknowledgements

The authors are grateful for support, assistance, and information provided by Statistics Iceland, Icelandic Directorate of Health, and Landspitali University Hospital. The study was funded in part with grants from the European Council, Nordisk Forskeruddannelsesakademi NorFA, the NATO Science Foundation, The University of Oslo, Reykjavik City Hospital, and the Icelandic Accident Prevention Council.