Clinico-Etiological Profile of Children Admitted with Head Injury in a Tertiary Health Care Centre During the COVID Pandemic

Abstract

Background The mechanism of injury, type of pathology, mode of management and specific problems, in the pediatric age group make these a unique population. The COVID-19 pandemic and lockdown caused a significant reduction in the number of road traffic accidents during the same period and the resultant number of head injuries in children.

Methods This was a descriptive study of 76 consecutive pediatric patients admitted with head injury between June and December 2020. Children under 18 years with head injury admitted in our hospital were included.

Results The most common etiology of pediatric head injury was found to be fall from height (61.8%) followed by road traffic accidents (27.6%). The most common age group affected was 1 to 5 years with a mean of 6.3 ± 5 years. Road traffic accidents were commonly seen in the 15 to 18 age group. The Glasgow Outcome Score (GOS) of 1 (death) was seen in one patient (1.3%) and low disability in 98.7% of patients.

Conclusion Falls formed the most important cause of pediatric head injury during this pandemic, and carefulness on the part of parents can help avoid dangerous consequences for the children. Recovery with minimal disability was observed in approximately all cases in this study. The number of severe traumatic brain injury was very low in this study. This can be attributed to the COVID-19 pandemic causing significant reduction in road traffic accidents and the number of severe head injury

Keywords

pediatric head injury - GCS - GOS

Consent to Participate

Informed consent was obtained from all parents of children included in the study. Informed assent was taken from patients between 12 and 18 years as per the WHO requirement.

Consent for Publication

The participants have consented to the submission of data obtained for the study to the journal.

Ethical Approval

Ethical committee approval was obtained prior to starting this study.

Publication History

Article published online:
23 January 2023

• References

• 1 Langlois JA, Rutland-Brown W, Thomas KE. The incidence of traumatic brain injury among children in the United States: differences by race. J Head Trauma Rehabil 2005; 20 (03) 229-238
• 2 Kraus JF, Rock A, Hemyari P. Brain injuries among infants, children, adolescents, and young adults. Am J Dis Child 1990; 144 (06) 684-691
• 3 Levin HS, Aldrich EF, Saydjari C. et al. Severe head injury in children: experience of the traumatic coma data bank. Neurosurgery 1992; 31 (03) 435-443 , discussion 443–444
• 4 Lamm R, Choueiri EM, Kloeckner JH. Accidents in the U.S. and Europe: 1970-1980. Accid Anal Prev 1985; 17 (06) 429-438
• 5 Lloyd L, Wallbank C, Broughton J. A collection of evidence for the impact of the economic recession on road fatalities in Great Britain. Accid Anal Prev 2015; 80: 274-285
• 6 Wegman F, Allsop R, Antoniou C. et al. How did the economic recession (2008-2010) influence traffic fatalities in OECD-countries?. Accid Anal Prev 2017; 102: 51-59
• 7 Yannis G, Papadimitriou E, Folla K. Effect of GDP changes on road traffic fatalities. Saf Sci 2014; 63: 42-49
• 8 Road traffic accidents 2019, Accessed September 30, 2022, at: https://morth.nic.in/sites/default/files/Click_for_the_Sundar_Committee_Report_on_Road_Safety_and_Traffic_Management.pdf
• 9 Radhakrishnan A. “Dip in road accidents by 32% in 2020”. The Hindu [Kerala] February 12, 2021. Accessed September 30, 2022, at: www.thehindu.com/news/national/kerala/dip-in-road-accidents-by-32-in-2020/article33823330
• 10 Sarla GS. COVID diaries: an Indian perspective. J Med Res Surg. 2020; 1 (03) 1-3
• 11 Da Dalt L, Marchi AG, Laudizi L. et al. Predictors of intracranial injuries in children after blunt head trauma. Eur J Pediatr 2006; 165 (03) 142-148
• 12 Faul M, Xu L, Wald MM, Coronado VG. Traumatic brain injury in the United States: emergency department visits, hospitalizations and deaths 2002–2006. Atlanta (GA): Centers for Disease Control and Prevention, National Center for Injury Prevention and Control; 2010
• 13 Mahapatra AK. Monitoring on pediatric head injuries patients. Neurology India (Suppl) 1995; 43: 67-70
• 14 Sambasivan M. Epidemeology-pediatric head injuries. Neurology India (Supple) 1995; 43: 57-58
• 15 El-Menyar A, Consunji R, Al-Thani H, Mekkodathil A, Jabbour G, Alyafei KA. Pediatric traumatic brain injury: a 5-year descriptive study from the National Trauma Center in Qatar. World J Emerg Surg 2017; 12: 48
• 16 King DR. Trauma in infancy and childhood: initial evaluation and management. Pediatr Clin North Am 1985; 32 (05) 1299-1310
• 17 Moront ML, Williams JA, Eichelberger MR, Wilkinson JD. The injured child. An approach to care. Pediatr Clin North Am 1994; 41 (06) 1201-1226
• 18 Ghosh, Arijit & Chattopadhyay, Aniruddha & Ghosal, Jayanta & Sarkar, Sumanta. (2022). Traumatic brain injury in pediatric patients –Clinical manifestations and outcome. Asian Journal of Medical Sciences 13: 208-212
• 19 Teasdale G, Jennett B. Assessment of coma and impaired consciousness. A practical scale. Lancet 1974; 2 (7872): 81-84
• 20 Reilly PL, Simpson DA, Sprod R, Thomas L. Assessing the conscious level in infants and young children: a paediatric version of the Glasgow Coma Scale. Childs Nerv Syst 1988; 4 (01) 30-33
• 21 Jennett B, Snoek J, Bond MR, Brooks N. Disability after severe head injury: observations on the use of the Glasgow Outcome Scale. J Neurol Neurosurg Psychiatry 1981; 44 (04) 285-293
• 22 Jennett B, Teasdale G, Galbraith S. et al. Severe head injuries in three countries. J Neurol Neurosurg Psychiatry 1977; 40 (03) 291-298
• 23 Tan RMR, Ganapathy S, Tyebally A. et al. Paediatric emergency department attendances during COVID-19 and SARS in Singapore. Ann Acad Med Singap 2021; 50 (02) 126-134
• 24 Sanford EL, Zagory J, Blackwell JM, Szmuk P, Ryan M, Ambardekar A. Changes in pediatric trauma during COVID-19 stay-at-home epoch at a tertiary pediatric hospital. J Pediatr Surg 2021; 56 (05) 918-922