Meredith L. Borland
Incidence of traumatic brain injuries in head-injured children with seizures
Borland, Meredith L.; Dalziel, Stuart R; Phillips, Natalie; Dalton, Sarah; Lyttle, Mark D; Bressan, Silvia; Oakley, Ed; Kochar, Amit; Furyk, Jeremy; Cheek, John A.; Neutze, Jocelyn; Eapen, Nitaa; Hearps, Stephen JC; Rausa, Vanessa C; Babl, Franz E.
Authors
Stuart R Dalziel
Natalie Phillips
Sarah Dalton
Mark Lyttle mark.lyttle@uwe.ac.uk
Silvia Bressan
Ed Oakley
Amit Kochar
Jeremy Furyk
John A. Cheek
Jocelyn Neutze
Nitaa Eapen
Stephen JC Hearps
Vanessa C Rausa
Franz E. Babl
Abstract
Objective: Incidence and short-term outcomes of clinically important traumatic brain injury (ciTBI) in head-injured children presenting to ED with post-traumatic seizure (PTS) is not described in current literature. Methods: Planned secondary analysis of a prospective observational study undertaken in 10 Australasian Paediatric Research in Emergency Department International Collaborative (PREDICT) network EDs between 2011 and 2014 of head-injured children <18 years with and without PTS. Clinical predictors and outcomes were analysed by attributable risk (AR), risk ratios (RR) and 95% confidence interval (CI), including the association with Glasgow Coma Scale (GCS) scores. Results: Of 20 137 head injuries, 336 (1.7%) had PTS with median age of 4.8 years. Initial GCS was 15 in 268/336 (79.8%, AR −16.1 [95% CI −20.4 to −11.8]), 14 in 24/336 (7.1%, AR 4.4 [95% CI 1.6–7.2]) and ≤13 in 44/336 (13.1%, AR 11.7 [95% CI 8.1–15.3]) in comparison with those without PTS, respectively. The ciTBI rate was 34 (10.1%) with PTS versus 219 (1.1%) without PTS (AR 9.0 [95% CI 5.8–12.2]) with 5/268 (1.9%), 6/24 (25.0%) and 23/44 (52.3%) with GCS 15, 14 and ≤13, respectively. In PTS, rates of admission ≥2 nights (34 [10.1%] AR 9.0 [95% CI 5.8–12.3]), intubation >24 h (9 [2.7%] AR 2.5 [95% CI 0.8–4.2]) and neurosurgery (8 [2.4%] AR 2.0 [95% CI 0.4–3.7]), were higher than those without PTS. Children with PTS and GCS 15 or 14 had no neurosurgery, intubations or death, with two deaths in children with PTS and GCS ≤13. Conclusions: PTS was uncommon in head-injured children presenting to the ED but associated with an increased risk of ciTBI in those with reduced GCS on arrival.
Journal Article Type | Article |
---|---|
Acceptance Date | Oct 5, 2022 |
Online Publication Date | Nov 2, 2022 |
Publication Date | Apr 1, 2023 |
Deposit Date | Nov 13, 2022 |
Publicly Available Date | Nov 14, 2022 |
Journal | EMA - Emergency Medicine Australasia |
Print ISSN | 1742-6731 |
Electronic ISSN | 1742-6723 |
Publisher | Wiley |
Peer Reviewed | Peer Reviewed |
Volume | 35 |
Issue | 2 |
Pages | 289-296 |
DOI | https://doi.org/10.1111/1742-6723.14112 |
Keywords | Acute brain injury, child, head injuries, seizures |
Public URL | https://uwe-repository.worktribe.com/output/10121790 |
Publisher URL | https://onlinelibrary.wiley.com/doi/10.1111/1742-6723.14112 |
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