The prognostic value of injury severity, location of event, and age at injury in pediatric traumatic head injuries

Original Research

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Authors: Jonas G Halldorsson, Kjell M Flekkoy, Gudmundur B Arnkelsson, Kristinn Tomasson, Kristinn R Gudmundsson, Eirikur Orn Arnarson

Published Date April 2008 Volume 2008:4(2) Pages 405 - 412

DOI: http://dx.doi.org/10.2147/NDT.S2035

Jonas G Halldorsson¹, Kjell M Flekkoy², Gudmundur B Arnkelsson³, Kristinn Tomasson⁴, Kristinn R Gudmundsson⁵, Eirikur Orn Arnarson^1,6

¹Psychological Health Services, Landspitali University Hospital, Reykjavik, Iceland; ²Department of Psychology, University of Oslo, and Department of Geriatric Medicine, Ulleval University Hospital, Oslo, Norway; ³Department of Psychology, University of Iceland, Reykjavik, Iceland; ⁴Administration of Occupational Safety and Health, Reykjavik, Iceland; ⁵Department of Neurosurgery, Landspitali University Hospital, Reykjavik, Iceland; ⁶Faculty of Medicine, University of Iceland, Reykjavik, Iceland

Aims: To estimate the prognostic value of injury severity, location of event, and demographic parameters, for symptoms of pediatric traumatic head injury (THI) 4 years later.

Methods: Data were collected prospectively from Reykjavik City Hospital on all patients age 0–19 years, diagnosed with THI (n = 408) during one year. Information was collected on patient demographics, location of traumatic event, cause of injury, injury severity, and ICD-9 diagnosis. Injury severity was estimated according to the Head Injury Severity Scale (HISS). Four years post-injury, a questionnaire on late symptoms attributed to the THI was sent.

Results: Symptoms reported were more common among patients with moderate/severe THI than among others (p < 0.001). The event location had prognostic value (p < 0.05). Overall, 72% of patients with moderate/severe motor vehicle-related THI reported symptoms. There was a curvilinear age effect (p < 0.05). Symptoms were least frequent in the youngest age group, 0–4 years, and most frequent in the age group 5–14 years. Gender and urban/rural residence were not significantly related to symptoms.

Conclusions: Motor vehicle related moderate/severe THI resulted in a high rate of late symptoms. Location had a prognostic value. Patients with motor vehicle-related THI need special consideration regardless of injury severity.

Keywords: follow-up, pediatric, symptoms, traumatic head injury

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