Age predicts likelihood for surgery for pediatric tbi: an analysis of 1745 hospitlizations from a Chinese Children's Hospital

Childs Nerv Syst. 2023 Sep;39(9):2487-2492. doi: 10.1007/s00381-023-05975-4. Epub 2023 May 5.

Abstract

Purpose: We tested the role of age and sex in surgery following pediatric TBI hospitalization.

Methods: Records of 1745 children hospitalized at a pediatric neurotrauma center in China included age, sex, cause of injury, diagnosis of injury, days of hospitalization, in-house rehabilitation, Glasgow Coma Scale score, mortality, 6-month post-discharge Glasgow Outcome Scale score, and surgery intervention. The children were 0-13 years (M= 3.56 years; SD = 3.06), with 47.4% 0-2 years of age.

Results: The mortality rate was 1.49%. Logistic regression on 1027 children with epidural hematoma, subdural hematoma, intracerebral hemorrhage, and intraventricular hemorrhage showed that controlling for other variables, the odds for younger children to receive surgery was statistically lower for epidural hematomas (OR = 0.75; 95% CI = 0.68-0.82), subdural hematomas (OR = 0.59; 95% CI = 0.47-0.74), and intraventricular hemorrhage (OR = 0.52; 95% CI = 0.28-0.98).

Conclusions: While severity of TBI and type of TBI were expected predictors for surgery, a younger age also predicted a significantly lower likelihood of surgery in our sample. Sex of the child was unrelated to surgical intervention.

Keywords: Age of injury; Pediatric TBI; Surgical decision; Surgical treatment.

MeSH terms

  • Aftercare
  • Brain Injuries, Traumatic* / complications
  • Cerebral Hemorrhage / complications
  • Child
  • East Asian People
  • Glasgow Coma Scale
  • Hematoma, Epidural, Cranial* / etiology
  • Hematoma, Epidural, Cranial* / surgery
  • Hematoma, Subdural / complications
  • Hospitals
  • Humans
  • Patient Discharge
  • Retrospective Studies