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037. Characteristics, Etiology and Clinical Inpatient Outcomes of Pediatric Traumatic Brain Injury

Authors: Nicole Eva Hernandez

Introduction:
Traumatic brain injury (TBI) in pediatric patients is a major burden to public health. Understanding predictive factors of severity and short hospitalization (?1 day length of stay) is needed to better inform management paradigms and optimize triage.Methods: A retrospective review of the Kids' Inpatient Database (KID) was performed for all data reported between 2006-2016 for TBI patients aged ?20 years. Univariate and multivariate regression analyses were performed to identify predictive factors of trauma severity and short hospitalization.
Results:
A total of 220,777 pediatric TBI cases were identified, with the majority of cases being boys (66%) at a mean age of 11.5 ± 0.02 years. Mean length of stay was 5.0 ± 0.03 days, with 25% discharged home within 1 day of hospitalization. In-hospital mortality occurred in 4% of cases. More severe TBI presentations were significantly and independently associated with older age, weekend admissions, hospital transfers (p < 0.01). Furthermore, children with chronic conditions and pre-existing neurological issues remained in hospital for a longer period of time (p < 0.01). There were 38% of admission that were short hospitalizations. Younger age, male gender, less chronic conditions, fall and assault etiologies, with milder injury severity all significantly and independently predicted greater likelihood of short hospitalization and early discharge home without further surgical management.
Conclusion:
The severity of pediatric TBI admissions to hospital can be impacted by a number of parameters. Furthermore, there exists a subset of predictive parameters for short hospitalization admissions. Proactive identification of these parameters at time of presentation will assist in optimizing the management of pediatric TBI in the future.