Penetrating head injuries in children presenting to the emergency department in Australia and New Zealand: A PREDICT prospective study

Babl, Franz; Lyttle, Mark; Bressan, Silvia; Borland, Meredith; Phillips, Natalie; Kochar, Amit; Dalton, Sarah; Cheek, John; Gilhotra, Yuri; Furyk, Jeremy; Neutze, Jocelyn; Donath, Susan; Hearps, Stephen; Arpone, Marta; Crowe, Louise; Dalziel, Stuart; Barker, Ruth; Oakley, Ed

Abstract

© 2018 Paediatrics and Child Health Division (The Royal Australasian College of Physicians) Aim: Penetrating head injuries (pHIs) are associated with high morbidity and mortality. Data on pHIs in children outside North America are limited. We describe the mechanism of injuries, neuroimaging findings, neurosurgery and mortality for pHIs in Australia and New Zealand. Methods: This was a planned secondary analysis of a prospective observational study of children 24 h, admission >2 days and abnormal computed tomography). Results: Of 20 137 evaluable patients with a head injury, 21 (0.1%) were identified to have sustained a pHI. All injuries were of non-intentional nature, and there were no gunshot wounds. The mechanisms of injuries varied from falls, animal attack, motor vehicle crashes and impact with objects. Mean Glasgow Coma Scale on ED arrival was 10; 10 (48%) had a history of loss of consciousness, and 7 (33%) children were intubated pre-hospital or in the ED. Fourteen (67%) children underwent neurosurgery, two (10%) craniofacial surgery, and five (24%) were treated conservatively; four (19%) patients died. Conclusions: Paediatric pHIs are very rare in EDs in Australia and New Zealand but are associated with high morbidity and mortality. The absence of firearm-related injuries compared to North America is striking and may reflect Australian and New Zealand firearm regulations.

• Journal Article Type: Article
• Acceptance Date: Jan 16, 2018
• Online Publication Date: Mar 26, 2018
• Publication Date: Aug 1, 2018
• Deposit Date: Feb 6, 2018
• Publicly Available Date: Mar 26, 2019
• Journal: Journal of Paediatrics and Child Health
• Print ISSN: 1034-4810
• Electronic ISSN: 1440-1754
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 54
• Issue: 8
• Pages: 861-865
• DOI: https://doi.org/10.1111/jpc.13903
• Keywords: paediatric, brain injury, penetrating head injury
• Public URL: https://uwe-repository.worktribe.com/output/861928
• Publisher URL: https://doi.org/10.1111/jpc.13903
• Additional Information: Additional Information : This is the peer reviewed version of the following article: Babl, F., Lyttle, M., Bressan, S., Borland, M., Phillips, N. and Oakley, Ed (2018) Penetrating head injuries in children presenting to the emergency department in Australia and New Zealand. A PREDICT prospective study. Journal of Paediatrics and Child Health, which has been published in final form at https://doi.org/10.1111/jpc.13903. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.
• Contract Date: Apr 4, 2018