Scholarlink

Objective <p>This observational study aims to describe the characteristics and management of&#xa0;paediatric head-injured patients across different&#xa0;paediatric age groups, compared with adults.</p> Design <p>Secondary analysis of the CENTER-TBI study.</p> Setting <p>65 centers in Europe between December 2014 and December 2017.</p> Patients <p>Patients with traumatic brain injury (TBI) admitted to the hospital were divided into different age groups: paediatrics (pTBI, age ≤ 17 years), adults (18–65 years), and elderly (&gt; 65 years).&#xa0;Paediatrics were further subdivided into three groups: toddlers (from 0 to 4 years), children (from 5 to 12 years), and adolescents (from&#xa0;13 to 17 years).</p> Interventions <p>None.</p> Measurements and main results <p>3,661 patients were included in the analysis (2,138 admitted to the intensive care unit (ICU)&#xa0;and 1,523 to the ward). Among these, 227 were paediatric (27 toddlers [0–4 years], 65 children [5–12 years], and 135 adolescents [13–17 years]). Most pTBI patients admitted to the ICU presented with mild injuries (Glasgow Coma Scale [GCS] 13–15; 66%), although severe injuries (GCS ≤ 8) were more common in adolescents (23.8%). Susceptibility to neuroworsening and seizures was low in the&#xa0;paediatric group (6% and 3.5%, respectively). Intracranial pressure monitoring was performed in 52 (39.4%) of 132&#xa0;paediatric ICU patients. Paediatric patients received less intensive therapy&#xa0;targeted to the intracranial pressure (ICP) control particularly in toddlers.</p> <p>Age below 18 years was associated with a lower risk of poor neurological outcomes at six months, particularly in adolescents and children (odds ratio (OR) = 0.31<i>,</i> 95% confidence interval (CI) = 0.15–0.58 <i>p</i> &lt; 0.001 and OR = 0.29<i>,</i> 95% CI = 0.09–0.71, <i>p</i> &lt; 0.001, respectively). In toddlers, the association was not statistically significant (OR = 0.48, 95% CI = 0.07–1.94, <i>p</i> = 0.4).</p> Conclusions <p>Paediatric TBI differs significantly from non-paediatric cases, with predominantly mild injuries, lower neuroworsening rates, and less intensive management, especially in younger children. Outcomes at six months are generally more favorable in paediatric patients, emphasizing the need for age-specific management strategies in TBI care.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Paediatric traumatic brain injury: clinical presentation, treatment approaches, management strategies, and outcomes. Insights from the CENTER-TBI study

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年12月18日

查看全文
  • Francesca Graziano,
  • Angelo Guglielmi,
  • Michela Consonni,
  • Giorgia Ogliari,
  • Alexander Younsi,
  • Margherita Valla,
  • Melisa Polo Friz,
  • Carlo Giussani,
  • Paola Rebora,
  • Stefania Galimberti,
  • Andrew Maas,
  • Giuseppe Citerio,
  • Cecilia Åkerlund,
  • Krisztina Amrein,
  • Nada Andelic,
  • Lasse Andreassen,
  • Audny Anke,
  • Anna Antoni,
  • Gérard Audibert,
  • Philippe Azouvi,
  • Maria Luisa Azzolini,
  • Ronald Bartels,
  • Pál Barzó,
  • Romuald Beauvais,
  • Ronny Beer,
  • Bo-Michael Bellander,
  • Antonio Belli,
  • Habib Benali,
  • Maurizio Berardino,
  • Luigi Beretta,
  • Morten Blaabjerg,
  • Peter Bragge,
  • Alexandra Brazinova,
  • Vibeke Brinck,
  • Joanne Brooker,
  • Camilla Brorsson,
  • Andras Buki,
  • Monika Bullinger,
  • Manuel Cabeleira,
  • Alessio Caccioppola,
  • Emiliana Calappi,
  • Maria Rosa Calvi,
  • Peter Cameron,
  • Guillermo Carbayo Lozano,
  • Marco Carbonara,
  • Simona Cavallo,
  • Giorgio Chevallard,
  • Arturo Chieregato,
  • Hans Clusmann,
  • Mark Coburn,
  • Jonathan Coles,
  • Jamie D. Cooper,
  • Marta Correia,
  • Amra Čović,
  • Nicola Curry,
  • Endre Czeiter,
  • Marek Czosnyka,
  • Claire Dahyot Fizelier,
  • Paul Dark,
  • Helen Dawes,
  • Véronique De Keyser,
  • Vincent Degos,
  • Francesco Della Corte,
  • Hugo den Boogert,
  • Bart Depreitere,
  • Đula Đilvesi,
  • Abhishek Dixit,
  • Emma Donoghue,
  • Jens Dreier,
  • Guy Loup Dulière,
  • Ari Ercole,
  • Patrick Esser,
  • Erzsébet Ezer,
  • Martin Fabricius,
  • Valery L. Feigin,
  • Kelly Foks,
  • Shirin Frisvold,
  • Alex Furmanov,
  • Pablo Gagliardo,
  • Damien Galanaud,
  • Dashiell Gantner,
  • Guoyi Gao,
  • Pradeep George,
  • Alexandre Ghuysen,
  • Lelde Giga,
  • Ben Glocker,
  • Jagoš Golubovic,
  • Pedro A. Gomez,
  • Johannes Gratz,
  • Benjamin Gravesteijn,
  • Francesca Grossi,
  • Russell L. Gruen,
  • Deepak Gupta,
  • Juanita A. Haagsma,
  • Iain Haitsma,
  • Raimund Helbok,
  • Eirik Helseth,
  • Lindsay Horton,
  • Jilske Huijben,
  • Peter J. Hutchinson,
  • Bram Jacobs,
  • Stefan Jankowski,
  • Mike Jarrett,
  • Ji yao Jiang,
  • Faye Johnson,
  • Kelly Jones,
  • Mladen Karan,
  • Angelos G. Kolias,
  • Erwin Kompanje,
  • Daniel Kondziella,
  • Evgenios Kornaropoulos,
  • Lars Owe Koskinen,
  • Noémi Kovács,
  • Ana Kowark,
  • Alfonso Lagares,
  • Linda Lanyon,
  • Steven Laureys,
  • Fiona Lecky,
  • Didier Ledoux,
  • Rolf Lefering,
  • Valerie Legrand,
  • Aurelie Lejeune,
  • Leon Levi,
  • Roger Lightfoot,
  • Hester Lingsma,
  • Ana M. Castaño León,
  • Marc Maegele,
  • Marek Majdan,
  • Alex Manara,
  • Geoffrey Manley,
  • Costanza Martino,
  • Hugues Maréchal,
  • Julia Mattern,
  • Catherine McMahon,
  • Béla Melegh,
  • David Menon,
  • Tomas Menovsky,
  • Ana Mikolic,
  • Benoit Misset,
  • Visakh Muraleedharan,
  • Lynnette Murray,
  • Ancuta Negru,
  • David Nelson,
  • Virginia Newcombe,
  • Daan Nieboer,
  • József Nyirádi,
  • Otesile Olubukola,
  • Matej Oresic,
  • Fabrizio Ortolano,
  • Aarno Palotie,
  • Paul M. Parizel,
  • Jean François Payen,
  • Natascha Perera,
  • Vincent Perlbarg,
  • Paolo Persona,
  • Wilco Peul,
  • Anna Piippo-Karjalainen,
  • Matti Pirinen,
  • Dana Pisica,
  • Horia Ples,
  • Suzanne Polinder,
  • Inigo Pomposo,
  • Jussi P. Posti,
  • Louis Puybasset,
  • Andreea Radoi,
  • Arminas Ragauskas,
  • Rahul Raj,
  • Malinka Rambadagalla,
  • Isabel Retel Helmrich,
  • Jonathan Rhodes,
  • Sylvia Richardson,
  • Sophie Richter,
  • Samuli Ripatti,
  • Saulius Rocka,
  • Cecilie Roe,
  • Olav Roise,
  • Jonathan Rosand,
  • Jeffrey V. Rosenfeld,
  • Christina Rosenlund,
  • Guy Rosenthal,
  • Rolf Rossaint,
  • Sandra Rossi,
  • Daniel Rueckert Martin Rusnák,
  • Juan Sahuquillo,
  • Oliver Sakowitz,
  • Renan Sanchez Porras,
  • Janos Sandor,
  • Nadine Schäfer,
  • Silke Schmidt,
  • Herbert Schoechl,
  • Guus Schoonman,
  • Rico Frederik Schou,
  • Elisabeth Schwendenwein,
  • Charlie Sewalt,
  • Ranjit D. Singh,
  • Toril Skandsen,
  • Peter Smielewski,
  • Abayomi Sorinola,
  • Emmanuel Stamatakis,
  • Simon Stanworth,
  • Robert Stevens,
  • William Stewart,
  • Ewout W. Steyerberg,
  • Nino Stocchetti,
  • Nina Sundström,
  • Riikka Takala,
  • Viktória Tamás,
  • Tomas Tamosuitis,
  • Mark Steven Taylor,
  • Aurore Thibaut,
  • Braden Te Ao,
  • Olli Tenovuo,
  • Alice Theadom,
  • Matt Thomas,
  • Dick Tibboel,
  • Marjolein Timmers,
  • Christos Tolias,
  • Tony Trapani,
  • Cristina Maria Tudora,
  • Andreas Unterberg,
  • Peter Vajkoczy,
  • Shirley Vallance,
  • Egils Valeinis,
  • Zoltán Vámos,
  • Mathieu van der Jagt,
  • Gregory Van der Steen,
  • Joukje van der Naalt,
  • Jeroen T. J. M. van Dijck,
  • Inge A. M. van Erp,
  • Thomas A. van Essen,
  • Wim Van Hecke,
  • Caroline van Heugten,
  • Ernest van Veen,
  • Thijs Vande Vyvere,
  • Roel P. J. van Wijk,
  • Alessia Vargiolu,
  • Emmanuel Vega,
  • Kimberley Velt,
  • Jan Verheyden,
  • Paul M. Vespa,
  • Anne Vik,
  • Rimantas Vilcinis,
  • Victor Volovici,
  • Nicole von Steinbüchel,
  • Daphne Voormolen,
  • Petar Vulekovic,
  • Kevin K. W. Wang,
  • Daniel Whitehouse,
  • Eveline Wiegers,
  • Guy Williams,
  • Lindsay Wilson,
  • Stefan Winzeck,
  • Stefan Wolf,
  • Zhihui Yang,
  • Peter Ylén,
  • Frederick A. Zeiler,
  • Veronika Zelinkova,
  • Agate Ziverte,
  • Tommaso Zoerle

摘要

Objective

This observational study aims to describe the characteristics and management of paediatric head-injured patients across different paediatric age groups, compared with adults.

Design

Secondary analysis of the CENTER-TBI study.

Setting

65 centers in Europe between December 2014 and December 2017.

Patients

Patients with traumatic brain injury (TBI) admitted to the hospital were divided into different age groups: paediatrics (pTBI, age ≤ 17 years), adults (18–65 years), and elderly (> 65 years). Paediatrics were further subdivided into three groups: toddlers (from 0 to 4 years), children (from 5 to 12 years), and adolescents (from 13 to 17 years).

Interventions

None.

Measurements and main results

3,661 patients were included in the analysis (2,138 admitted to the intensive care unit (ICU) and 1,523 to the ward). Among these, 227 were paediatric (27 toddlers [0–4 years], 65 children [5–12 years], and 135 adolescents [13–17 years]). Most pTBI patients admitted to the ICU presented with mild injuries (Glasgow Coma Scale [GCS] 13–15; 66%), although severe injuries (GCS ≤ 8) were more common in adolescents (23.8%). Susceptibility to neuroworsening and seizures was low in the paediatric group (6% and 3.5%, respectively). Intracranial pressure monitoring was performed in 52 (39.4%) of 132 paediatric ICU patients. Paediatric patients received less intensive therapy targeted to the intracranial pressure (ICP) control particularly in toddlers.

Age below 18 years was associated with a lower risk of poor neurological outcomes at six months, particularly in adolescents and children (odds ratio (OR) = 0.31, 95% confidence interval (CI) = 0.15–0.58 p < 0.001 and OR = 0.29, 95% CI = 0.09–0.71, p < 0.001, respectively). In toddlers, the association was not statistically significant (OR = 0.48, 95% CI = 0.07–1.94, p = 0.4).

Conclusions

Paediatric TBI differs significantly from non-paediatric cases, with predominantly mild injuries, lower neuroworsening rates, and less intensive management, especially in younger children. Outcomes at six months are generally more favorable in paediatric patients, emphasizing the need for age-specific management strategies in TBI care.