Author (year) | Country and Study duration | Study sample size and Inclusion/exclusion criteria | Mechanism of Injury | Injury severity | Incidence/mortality |
---|---|---|---|---|---|
Iranmanesh (2009) [23] | Iran, 2003–2005 | 380 head trauma Inclusion: patients admitted with brain injury; age < 18 years Exclusion: not reported | MVC 72%; falls 11% | No GCS reported; abnormal skull radiographs 12%; abnormal brain-CT scans 17% | Head trauma was 32%. Most affected age groups: 7–12 years (43%) and 12–18 years (35%). TBI mortality 7% |
Assiry et al. (2014) [20] | KSA, 2012- | 71 head trauma Inclusion: pediatric head trauma (age ≤ 16 years). Exclusion: not reported | MVC 63%; falls 32% | Not reported | Most affected age group: > 7–16 years (55%) |
Alhabdan et al. (2013) [12] | KSA, 2001–2009 | 1219 head trauma Inclusion: any head injury in pediatric patients (age ≤ 18 years); patients admitted or died at ED Exclusion: not reported | MVC (34%); pedestrian (30%); falls (28%). | Median (range) GCS 11 (3–15); mean ISS 16.6 (range 1–75) | Most affected age group: < 12 years (66%); Mortality 15%; 50% died on arrival |
Fakharian et al. (2014) [24] | Iran, 2004–2010 | 604 infant head trauma Inclusion: infants (< 24 months) with head trauma; hospitalized for > 24 h. Exclusion: birth trauma | Falls (63%) | GCS: (14–15) 99%; (≤ 13) 1%; mean GCS 14.93 ± 0.8 | Head trauma in infants (≤ 24 m) was 21% of all children (< 15 years); mortality 0.8%; in-hospital mortality 6.6 per 100,000 infants. |
Lotfi-Sadigh et al. (2015) [25] | Iran, 2011–2014 | 218 children with blunt head trauma Inclusion: minor blunt head trauma (GCS 14 or 15); presented to ED within 24 h of trauma; age < 2 years. Exclusion: no signs or symptoms of head trauma other than scalp abrasions or lacerations; penetrating trauma; comorbidities (ventricular shunt or bleeding disorders); previous neuroimaging; patients left ED against medical advice | Falls 74%; MVC 14% | Head trauma was defined as GCS 14 or 15; abnormal CT findings in 8% | No mortality was reported due to mild head trauma |
Alharthy et al. (2015) [26] | KSA, 2011 | 289 children with blunt head trauma. Inclusion: blunt head injury; age 1–14 years; GCS 13–15; presentation within 24 h post-injury; CT scan done. Exclusion: penetrating head trauma, local facial signs post trauma, signs of basal skull Fracture; comorbidities that predispose to bleeding tendency; multiple major traumas; prolonged amnesia and LOC (prolonged amnesia and loss of consciousness for more than 5 min); active seizure on arrival to ED; GCS < 13. | Falls 53%; MVC 23% | All cases were with minor head trauma; GCS 15 (94%); 14 (4%); 13 (2%); abnormal brain CT findings in 5% (of these, 53% in falls, 23% in MVC) | TBI in minor head trauma among children (1–14 years) was 5%; no mortality was reported due to mild head trauma |
Yagmur et al. (2016) [27] | Turkey, 2008–2012 | 203 pre-school children deaths due to head trauma. Inclusion: fatal head trauma in pre-school children (age ≤ 5 years); head trauma with general body trauma if cause of death was head trauma. Exclusion: cause of death other than head trauma | Falls 48%; MVC 33% | All cases were fatal | 18% of deaths among children (age ≤ 5 years) were due to head trauma |
Klimo et al. (2015) [28] | Iraq, 2004–2012 | 268 children with severe isolated head trauma in Iraq during Operation Iraqi Freedom (OIF). Inclusion: pediatric head injury; age < 18 years; isolated serious head injury (defined as AIS > 3); during OEF (Operation Enduring Freedom) or OIF (Operation Iraqi Freedom). Exclusion: not reported | Penetrating injuries 61%; caused by IED (38%) or blast (25%). | Median (range) GCS 7 (3–15) | Of the total severe isolated head trauma among children during US military operation in Iraq and Afghanistan, 41% were Iraqi children. Mortality among the severe isolated head trauma in children was 26% |
Gofin and Avitzour (2007) [29] | Israel, 2001 | 472 head trauma in children; Inclusion: pediatric head trauma; age 0–17 years; Israeli citizens; information about mechanism and type of injury were available. Exclusion: not reported TBI definition by ICD-9-CM codes | Falls 46% | GCS was not reported; ISS was >16 in 60% | 42% of the head trauma in children (0–17 years) was TBI or possible TBI. Most affected age group: 0–4 years (51% in Jews and 57% in Arabs) |
Present study | Qatar, 2010–2014 | 167 pediatric TBI cases (≤ 18 years); Inclusion: all pTBI cases required admission, ICD-9 codes from 800 to 959.9 Exclusion: codes 905–909.9; 910–924.9 and 930–939.9 | MVC 47%; falls 22% | Median (range) GCS at scene: 9 (3–15); Median (range) ISS: 19 (1–50) | 18% of the total TBIs were in children; overall rate of TBIs among children in Qatar 9.5 per 100,000; most affected age group was 15–18 years (40%) followed by 0–4 years (23%). Mortality 13% |