Article
Head trauma in children: recent epidemiology and outcome
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Authors
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T. Kapapa
- Klinik für Neurochirurgie, Universitätsklinikum Ulm, Ulm
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A. Pala
- Klinik für Neurochirurgie, Universitätsklinikum Ulm, Ulm
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M. Kapapa
- Sektion Kinderchirurgie, Universitätsklinikum Ulm, Ulm
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C. Posovszky
- Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Ulm, Ulm
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M. Perl
- Klinik für Unfall-, Hand-, Plastische- und Wiederherstellungschirurgie, Universitätsklinikum Ulm, Ulm
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E. Rickels
- Klinik für Unfallchirurgie, Orthopädie und Neurotraumatologie, Allgemeines Krankenhaus Celle, Celle
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D. Woischneck
- Klinik für Neurochirurgie, Klinikum Landshut, Landshut
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C.R. Wirtz
- Klinik für Neurochirurgie, Universitätsklinikum Ulm, Ulm
| Published: | April 28, 2011 |
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Outline
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Objective: According to the German Federal Office of Statistics, the number of children treared for head injuries is still increasing, especially in younger children (1-4 years). An earlier confrontation with wheeled toys like bogie wheels is assumed. We performed a data acquisition in children treated in our hospital.
Methods: All children aged between 0-18 years, who were treated in the year 2010 for head trauma (ICD 10; S06.0-9) are included. Treating departments included traumatology, paediatrics, paediatric-surgery and neurosurgery. Data of demographics, mechanism of trauma, clinical status at admission and course of treatment as well as the outcome were collected. Significance was assumed by p ≤ 0.05.
Results: 389 children were treated for head injury from 1.1.2010 to 15.12.2010. There was a predominance of boys (1.5:1). The severity of trauma according to the Glasgow-Coma-Score (mild : moderate : severe) showed 95% : 2 : 3%. The distribution of age was < 1 year N = 43 (11.1%), 1-4 years N = 181 (46.5%), 5-10 years N = 103 (26.5%), 11-14 years N = 42 (10.8%), 15-18 years N = 20 (5.1%). The main cause of trauma changes with age (p < 0.034). Falls are dominating in the age of 0-4 years (49%), followed by traffic accidents and falls in the age group of 5-14 years (9.1% and 23.9%). Traffic accidents are the main cause in the age group of 15-18 years (2.9 %); bicyclist 17%, pedestrian 12.5% and car occupant 57%. The second quarter of the year is the one with the highest number of patients (31.4%). The majority of admissions occurred on Fridays and between 7 and 8 p.m. (18%), respectively. The other weekdays showed the same (13%) (p < 0.43). Additive injuries are more frequent in children < 11 years (p = 0.024). Cranial surgical procedures were necessary in 2.5%, a decompressive hemicraniektomie had to be done five times. The mean length of stay was 2.5 days. More than 2/3 of the children could be discharged to their families.
Conclusions: The hypothesis that wheeled toys are the cause of the increasing number of head injured children could not be confirmed. However, we are able to confirm the high number of children at an age of 1-4 years. The main causes of head injury are age-dependent falls and traffic accidents. The elevated number (10 %) of falls in children aged < 1 year is alarming. There is still need for prevention to reduce the number of head trauma in children.
