The following is a summary of “Emergency department visits for mild traumatic brain injury in early childhood,” published in the March 2023 issue of Emergency Medicine by Rose, et al.

Key stages of neurodevelopment may be disrupted by brain damage in young children. School-aged children have been the subject of the majority of studies on mild traumatic brain injury (mTBI). For a study, researchers sought to describe the prevalence and healthcare use of mTBI in young children visiting emergency departments (ED) in the United States.

For children with mTBI aged 0 to 6 years, the Nationwide Emergency Department Sample was surveyed from 2016 to 2019. Patients were disqualified if they had focal or diffuse TBI, used a drowning or abuse method, died in the ER or hospital, had an Injury Severity Score of >15 or higher, required intubation, or had received a blood product transfusion.

According to estimates at the national level, 1,372,291 patient visits included 69.4% fall injuries, 63.5% patients who were two years old or younger, and 57.5% men. “Unspecified damage of the head” (83%) was the most frequent diagnosis for head injuries; as patients’ ages rose, concussions became more common. The majority of patients were seen in emergency departments with low pediatric patient volumes (64.5%), non-children’s hospital EDs (86.2%), and non-teaching hospitals (64.9%). In the ED, more than 98% of patients were treated and sent home. Less frequently at children’s hospitals, computed tomography of the head and cervical spine was conducted in 18.7% and 1.6% of patients, respectively (OR = 0.55, 95% CI = 0.41-0.76 for the head and OR = 0.19, 95%CI = 0.11-0.34 for the cervical spine). Over half of the patients used Medicaid, and ED costs ranged from $540 to $681 million yearly.

In the United States, early childhood mTBI is common and expensive. Diagnostic coding and computed tomography scans differ greatly amongst EDs. To find the best management techniques and diagnostic tools, more concentrated research was required.

Reference: sciencedirect.com/science/article/pii/S0735675722007756