Mortality and Morbidity of Severe Traumatic Brain Injuries; A Pediatric Intensive Care Unit Experience over 15 Years

Objective: to determine the mortality, morbidity, types of intracranial hemorrhages, and factors associated with length of stay (los) associated with accidental traumatic brain injury (tbi) at a pediatric intensive care unit (picu) of a regional trauma center in an asian city. methods: this study is a retrospective review of types of head injury, mortality and morbidity demographics of patients admitted to a picu with tbi. all patients with accidental tbi were included, namely road traffic injury (rti) and fall, and their demographics compared. non-accidental injuries (nai) were excluded. results: 95 children (78% males) were admitted to a picu with rti or falls from 2002 to 2017. they accounted for 3.7% of picu admissions. comparing with falls, victims of rti were older (p<0.001) and more likely to suffer from skull fracture (p=0.017). there were 4 deaths with falls (6.8%) but none with rti. subarachnoid hemorrhages, extradural hemorrhages, the use of mechanical ventilation, inotropes and neurological supports were associated with longer los in picu in these injuries (p<0.001). conclusion: a longer picu los is associated with extradural and subarachnoid hemorrhages, usage of inotropes, mechanical ventilation and neurological supports in falls and rti. three-quarters of victims are males. preventive health education should be especially directed to boys to reduce severe tbi in this asian city.