Department of Paediatrics, KK Women and Children's Hospital, Singapore.
Ann Acad Med Singap. 2021 Feb;50(2):119-125. doi: 10.47102/annals-acadmedsg.2020274.
Head injuries occur commonly in children and can lead to concussion injuries. We aim to describe the epidemiology of head injuries among school-going children and identify predictors of brain concussions in Singapore.
This is a retrospective study of children 7-16 years old who presented to the Emergency Department (ED) of KK Women's and Children's Hospital in Singapore with minor head injury between June 2017 and August 2018. Data including demographics, clinical presentation, ED and hospital management were collected using a standardised electronic template. Multivariable logistic regression analysis was performed to identify early predictors for brain concussion. Concussion symptoms were defined as persistent symptoms after admission, need for inpatient intervention, or physician concerns necessitating neuroimaging.
Among 1,233 children (mean age, 6.6 years; 72.6% boys) analysed, the commonest mechanism was falls (64.6%). Headache and vomiting were the most common presenting symptoms. A total of 395 (32.0%) patients required admission, and 277 (22.5%) had symptoms of concussion. Older age (13-16 years old) (adjusted odds ratio [aOR] 1.53, 95% confidence interval [CI] 1.12-2.08), children involved in road traffic accidents (aOR 2.12, CI 1.17-3.85) and a presenting complaint of headache (aOR 2.64, CI 1.99-3.50) were significantly associated with symptoms of concussion.
This study provides a detailed description of the pattern of head injuries among school-going children in Singapore. High risk patients may require closer monitoring to detect post-concussion syndrome early.
头部损伤在儿童中较为常见，可导致脑震荡损伤。本研究旨在描述新加坡学龄儿童头部损伤的流行病学情况，并确定脑震荡的预测因素。
这是一项回顾性研究，纳入了 2017 年 6 月至 2018 年 8 月期间因轻度头部损伤到新加坡 KK 妇女儿童医院急诊科就诊的 7-16 岁儿童。使用标准化电子模板收集了包括人口统计学、临床表现、急诊科和医院管理在内的数据。采用多变量逻辑回归分析来确定脑震荡的早期预测因素。脑震荡症状定义为入院后持续存在的症状、需要住院干预或医生认为需要神经影像学检查的症状。
在纳入的 1233 名儿童（平均年龄为 6.6 岁，72.6%为男孩）中，最常见的损伤机制是跌倒（64.6%）。头痛和呕吐是最常见的症状。共有 395 名（32.0%）患者需要住院治疗，277 名（22.5%）出现脑震荡症状。年龄较大（13-16 岁）（调整后的优势比 [aOR] 1.53，95%置信区间 [CI] 1.12-2.08）、涉及道路交通意外（aOR 2.12，CI 1.17-3.85）和以头痛为主要症状（aOR 2.64，CI 1.99-3.50）的儿童与脑震荡症状显著相关。
本研究详细描述了新加坡学龄儿童头部损伤的模式。高危患者可能需要更密切的监测，以尽早发现脑震荡后综合征。
