Incidence and mortality of moderate and severe traumatic brain injury in children: A ten year population-based cohort study in Norway

Mari Olsen; Anne Vik; Tom Ivar Lund Nilsen; Oddvar Uleberg; Kent Gøran Moen; Oddrun Fredriksli; Espen Lien; Torun Gangaune Finnanger; Toril Skandsen

doi:10.1016/j.ejpn.2019.01.009

Incidence and mortality of moderate and severe traumatic brain injury in children: A ten year population-based cohort study in Norway

Eur J Paediatr Neurol. 2019 May;23(3):500-506. doi: 10.1016/j.ejpn.2019.01.009. Epub 2019 Mar 4.

Authors

Mari Olsen¹, Anne Vik², Tom Ivar Lund Nilsen³, Oddvar Uleberg⁴, Kent Gøran Moen⁵, Oddrun Fredriksli⁶, Espen Lien⁷, Torun Gangaune Finnanger⁸, Toril Skandsen⁹

Affiliations

¹ Clinic of Physical Medicine and Rehabilitation, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway; Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, NTNU, Trondheim, Norway. Electronic address: mari.olsen@ntnu.no.
² Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, NTNU, Trondheim, Norway; Department of Neurosurgery, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway. Electronic address: ann.vik@ntnu.no.
³ Department of Public Health and Nursing, Norwegian University of Science and Technology, NTNU, Trondheim, Norway; Clinic of Anaesthesia and Intensive Care, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway. Electronic address: tom.nilsen@ntnu.no.
⁴ Department of Emergency Medicine and Pre-hospital Services, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway; Department of Research and Development, Norwegian Air Ambulance Foundation, NO-0103, Oslo, Norway. Electronic address: Oddvar.Uleberg@stolav.no.
⁵ Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, NTNU, Trondheim, Norway; Department of Radiology, Nord-Trondelag Hospital Trust, Levanger, Norway. Electronic address: kent.g.moen@ntnu.no.
⁶ Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, NTNU, Trondheim, Norway; Department of Neurosurgery, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway. Electronic address: oddrun.fredriksli@ntnu.no.
⁷ Department of Pediatrics, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway. Electronic address: espen.lien@stolav.no.
⁸ Department of Pediatrics, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway. Electronic address: Torun.Gangaune.Finnanger@stolav.no.
⁹ Clinic of Physical Medicine and Rehabilitation, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway; Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, NTNU, Trondheim, Norway. Electronic address: toril.skandsen@ntnu.no.

PMID: 30879962
DOI: 10.1016/j.ejpn.2019.01.009

Abstract

Objective: In this study we wanted to estimate population-based rates of incidence and mortality of moderate and severe traumatic brain injury (TBI) in children in one specific region in Norway.

Methods: In the region there are seven acute care hospitals (ACHs) in addition to a Level 1 trauma centre. Of 702 869 inhabitants (2014), 145 395 were children aged 0-16 years. Data were collected during ten years (2004-2014). All children aged 0-16 years with moderate (Glasgow Coma Scale [GCS] score 9-13) or severe (GCS score ≤ 8) TBI admitted to the Level 1 trauma centre were prospectively included. Children treated outside the Level 1 trauma centre were retrospectively included from the ACHs. Children who died from TBI prehospitally were included from the National Cause of Death Registry. Poisson regression was used to estimate incidence rate ratios (with a 95% confidence interval) comparing age, sex, and time periods.

Results: A total of 71 children with moderate or severe TBI were identified. Crude incidence rates were 2·4 (95% CI 1·7-3·3) for moderate and 2·5 (95% CI 1·8-3·4) for severe TBI per 100 000 person-years (py). Mortality rate from TBI was 1·2 (95% CI 0·7-1·9) per 100 000 py, and 88% were prehospital deaths.

Conclusion: The incidence rates and mortality of moderate and severe TBI were low compared to international reports. Most likely explained by successful national prevention of TBI.

Keywords: Child; Children; Epidemiological study; Epidemiology; Head injury; Head trauma; Incidence; Mortality; Paediatric; Paediatric head injury; Paediatric traumatic brain injury; Population; Traumatic brain injury.

MeSH terms

Adolescent
Brain Injuries, Traumatic / epidemiology*
Child
Child, Preschool
Cohort Studies
Female
Humans
Incidence
Infant
Infant, Newborn
Male
Norway / epidemiology
Retrospective Studies