Christina M. Theodorou, Miriam Nuño, Kaeli J. Yamashiro, Erin G. Brown. Increased Mortality in Very Young Children with Traumatic Brain Injury Due to Abuse: A Nationwide Analysis of 10,965 Patients. Published:February 24, 2021DOI:https://doi.org/10.1016/j.jpedsurg.2021.02.044
Abstract
Background
: Traumatic brain injury (TBI) is the leading cause of death
and disability in young children; however, the impact of mechanism on outcomes
has not been fully evaluated. We hypothesized that children with TBI due to
abuse would have a higher mortality than children with accidental TBI due to
motor vehicle collisions (MVC).
Methods
: We performed a retrospective review of the National Kids’
Inpatient (KID) hospitalizations database of children <2 years old with TBI
due to abuse or MVC (2000-2016). The primary outcome was mortality. Secondary
outcomes were length of stay (LOS) and hospital charges. We investigated
predictors of mortality with multivariable regression.
Results
: Of 10,965 children with TBI, 65.2% were due to abuse.
Overall mortality was 9.8% (n=1074). Abused children had longer LOS (5.7 vs 1.6
days, p<0.0001) and higher hospital charges ($34,314 vs $19,360,
p<0.0001) than children with TBI due to MVC. The odds of mortality were 42%
higher in children with abusive head trauma (OR 1.42, 95% CI 1.10-1.83,
p=0.007) compared to MVCs after adjusting for age, race, sex, neurosurgical
intervention, injury severity, and insurance.
Conclusion
: Children with abusive traumatic brain injury have
increased risk of mortality, longer LOS, and higher hospital charges compared
to children with TBI due to motor vehicle collision after adjusting for
relevant confounders. Resources must be directed at prevention and early
identification of abuse.
Courtesy of: https://www.mdlinx.com/journal-summary/increased-mortality-in-very-young-children-with-traumatic-brain-injury-due-to-abuse-a-nationwide/1xRCvg28CgjPuqCcBrUS9a
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