Citation

Klimo P, Ragel BT, Armonda R, Kofford S, McCafferty RR. Neurosurgery 2013; 60(Suppl 1): 183-184.

Copyright

(Copyright © 2013, Congress of Neurological Surgeons)

DOI

10.1227/01.neu.0000432782.51224.8d

PMID

23839459

Abstract

INTRODUCTION: Children are the inevitable and unfortunate victims of armed conflicts throughout history. The operations in Afghanistan (Operation Enduring Freedom) and Iraq (Operation Iraqi Freedom) were no different. METHODS: Using the Joint Theater Trauma Registry (JTTR), which is the largest injury database in existence, we searched for all children (<18 years old) who sustained a severe head injury (defined as an AIS of 3 or more) during OEF or OIF from 2001 to August 31, 2010. A number of datapoints were collected, with the primary endpoint being in-hospital mortality. RESULTS: Five hundred thirty-nine children (m = 401, f = 138) met our criteria. The mean age was 7.9 (± 4.4). Blunt injury was the mechanism in 197 children; penetrating in 342. The average GCS on admission was 8.2. Intracranial pressure monitoring was performed in 198 patients (138 ventriculostomies, 60 bolts) and 118 underwent a craniotomy or craniectomy. The average length of stay and GCS at time of discharge was 5.5 days and 12.9, respectively. In-hospital death occurred in 127 (23.5%) children. There was no difference in mortality based on age, OEF vs OIF, gender and type of injury (penetrating vs non-penetrating). CONCLUSION: Many children who were injured as a result of combat operations or non-battlefield causes were cared for by coalition forces during OEF and OIF. Almost one-quarter of children with severe head injuries died. Given the challenging environment and limited available resources, coalition forces were able to provide quality and timely care.

Language: en