The outcome of severe traumatic brain injury in children in Qatar: Six-year study

摘要

The aim of this study was to determine the incidence pattern of the burden severe traumatic brain injuries (TBIs) among young children in Qatar and to suggest practical prevention policies that can be implemented in Qatar. This is a retrospective study that included all pediatric cases of severe TBI during the period from January 2002 to December 2008. The study was conducted among children aged 14 years or less at the Children Rehabilitation Unit, Pediatric Department, Hamad General Hospital. The Glasgow Coma Scale (GCS) was used to assess severity of TBIs. This study was based on 65 children suffering from severe traumatic brain injury, of which 12 of them died within the first month of admission in pediatric intensive care unit. The predominant gender was male (73.8%), of which non-Qataris form 50.8%. Predominant mechanisms of injury were road traffic accident (84.6%), then injuries due to falls (10.8%), followed by sports and recreation injuries. Among our patients 43.1% had spasticity, 33.8% experienced posttraumatic epilepsy. Better outcomes were observed after severe TBI among older children. The current study revealed that 24.6% had communication disorder, 26.2% had poor cognition, 24.6% had hemiplegia, 18.5% had abnormal behavior and 15.4% had a vegetative state. All the patients (98.5%) required physiotherapy and occupational therapy, 50.8% of them required speech therapy and swallowing assessment. Further, 47.7% required braces either ankle foot orthosis or hands splints; also, 16.9% required behavior therapy and we have used Botox injection in only 6.2% of the spastic patients. Finally, the incidence of TBIs from road traffic crashes and injuries in Qatar are increasing significantly compared to other developing and developed countries. In conclusion, the present study findings provided an overview of TBI in Qatar and mostly related to the road traffic crashes and injuries.