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Abstract
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BACKGROUND: Traumatic brain injury (TBI) is a common condition affecting children all over the world, and represents a global public health concern. It is unclear how geopolitical, societal, and ethnic differences may influence the nature of TBI among children.
METHODS: A comprehensive literature search was conducted incorporating studies with hospital-, regional-, or country-specific pediatric TBI epidemiology data published between 1995-2015. Incidence, age, severity, mechanism of injury, and other relevant injury characteristics were extracted and compared across diverse geographic regions.
RESULTS: Thirty articles met inclusion criteria, incorporating TBI data from more than 165,000 children on 5 continents. The worldwide incidence of pediatric TBI ranges broadly and varies greatly by country, with most reporting a range between 47-280 per 100,000 children. Over the age of 3, male children suffered higher rates of TBI than females. A bimodal age distribution is often described, with very young children (0-2 years) and adolescents (15-18) more commonly injured. Mild TBI (GCS ≥ 13) constitutes more than 80% of injuries, and up to 90% of all injuries are associated with negative imaging. Only a small fraction (<10%) requires surgical intervention. Independent of country or region of origin, the vast majority of children suffering TBI achieve a good clinical outcome. Hospital admission rates vary widely, with US patients more commonly admitted than those from other countries. Falls and motor vehicle collisions (MVC) represent the majority of injury mechanisms. In Africa and Asia, pedestrians were most commonly injured in MVCs, while vehicle occupants were more likely involved among Australian, European, and US populations. For children, non-accidental trauma was prevalent in developing and developed nations alike.
CONCLUSIONS: TBI is a relatively common entity stretching across traditional geographic and demographic boundaries, and affecting pediatric populations worldwide. Continued civil infrastructure development and public health policy reforms may help to reduce the societal burden of pediatric TBI.
Copyright © 2015 Elsevier Inc. All rights reserved.
Language: en |