Department of Neurological Surgery, University of Miami Miller School of Medicine, 1095 NW 14th Terrace, Miami, FL, 33136, USA.
Department of Neurological Surgery, Nicklaus Children's Hospital, Miami, FL, USA.
Childs Nerv Syst. 2022 Aug;38(8):1541-1547. doi: 10.1007/s00381-022-05544-1. Epub 2022 May 2.
Traumatic brain injury (TBI) in pediatric patients is a major burden to public health. Understanding clinical associations with severity and short hospitalization (≤ 1 day length of stay) is needed to better inform management paradigms and optimize triage.
A retrospective review of the Kids' Inpatient Database (KID) was performed for all data reported between 2006 and 2012 for TBI patients aged ≤ 20 years. Univariate and multivariate regression analyses were performed to identify predictive factors of trauma severity and short hospitalization.
A total of 220,777 pediatric TBI cases were identified, with the majority of cases being boys (66%) with a mean age of 11.5 years. Mean length of stay was 5.0 days, with 25% discharged within 1 day, and 83% routinely discharged home. In-hospital mortality occurred in 4% of cases. More severe TBI presentations were significantly and independently associated with older age, weekend admissions, hospital transfers, and in patients with chronic conditions and neurological issues (all P < 0.01). There were 38% of admission that were short hospitalizations. Younger age, male gender, less chronic conditions, fall and assault etiologies, and with milder injury severity all significantly and independently predicted greater likelihood of short hospitalization.
The severity of pediatric TBI admissions to the hospital can be impacted by a number of parameters. Furthermore, there exists a subset of clinical associations for short hospitalization admissions. Proactive identification of these parameters at time of presentation will assist in optimizing the management of pediatric TBI].
儿童创伤性脑损伤（TBI）是公共卫生的主要负担。为了更好地告知管理模式并优化分诊，需要了解与严重程度和短住院时间（≤1 天住院时间）相关的临床关联。
对 2006 年至 2012 年期间报告的所有年龄≤20 岁的 TBI 患者的儿童住院患者数据库（KID）进行回顾性分析。进行单变量和多变量回归分析，以确定创伤严重程度和短住院时间的预测因素。
共确定了 220777 例儿科 TBI 病例，大多数为男孩（66%），平均年龄为 11.5 岁。平均住院时间为 5.0 天，25%的患者在 1 天内出院，83%的患者常规出院回家。住院期间死亡率为 4%。更严重的 TBI 表现与年龄较大、周末入院、医院转院以及患有慢性疾病和神经系统问题的患者显著且独立相关（均 P<0.01）。有 38%的入院是短时间住院。年龄较小、男性、较少的慢性疾病、跌倒和攻击病因以及较轻的损伤严重程度均显著且独立地预测更有可能进行短时间住院。
医院收治的儿科 TBI 严重程度可受到多种参数的影响。此外，短时间住院的入院存在一组特定的临床关联。在就诊时主动识别这些参数将有助于优化儿科 TBI 的管理。
