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Citation
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An SJ, Kumwenda K, Peiffer S, Davis D, Gallaher J, Charles A. World Neurosurg. 2023; ePub(ePub): ePub. |
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Abstract
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BACKGROUND: Pediatric injuries contribute to substantial mortality and morbidity worldwide, particularly in sub-Saharan Africa. We aim to identify predictors of mortality and time trends for pediatric traumatic brain injuries (TBI) in Malawi.
METHODS: We performed a propensity-matched analysis of data from the trauma registry at Kamuzu Central Hospital in Malawi from 2008-2021. All children ≤16 years were included. Demographic and clinical data were collected. Outcomes were compared between patients with and without head injuries.
RESULTS: A cohort of 54,878 patients was included, with 1,755 having TBI. The mean ages of patients with and without TBI were 7.8±7.8 years and 7.1±4.5 years, respectively. The most common mechanism for patients with and without TBI was road traffic injury and falls, respectively (48.2% versus 47.8%, p<0.01). The crude mortality rate for the TBI cohort was 20.9% compared to 2.0% in the non-TBI cohort (p<0.01). After propensity matching, patients with TBI had 4.7 higher odds of mortality (95% confidence interval 1.9-11.8). Over time, patients with TBI had an increasing predicted probability of mortality for all age categories, with the most significant increase among children younger than one year.
CONCLUSIONS: TBI confers a greater than 4-fold higher likelihood of mortality in this pediatric trauma population in a low-resource setting. These trends have worsened over time.
Language: en |