Pattern and outcome of pediatric head injuries in the Suez Canal Region: A follow-up study

BACKGROUND: A significant number of children sustain a head injury every year. Despite this, few studies in Egypt have provided detailed information about these injuries.
AIM: The aim of this study was to investigate the epidemiology and outcome of head injury among children presenting to the emergency department in the Suez Canal University Hospital.
MATERILAS AND METHODS: A clinical follow-up study including 70 patients, aged 18 years or less, who presented to the emergency department, with head injuries, in the period from March 2014 to February 2015. Patients were grouped according to their ages into three subgroups: <2, 2–5, and >5 years old. Collected data included patients’ demographics, causes, severity, timing of injuries, and the eventual outcome after a follow-up period of 3 months. Severity of head injury was based on the general level of consciousness using the Pediatric Glasgow Coma Scale. The functional outcome at final follow-up was assessed using the King’s Outcome Scale for Childhood Head Injury.
RESULTS: Male-to-female ratio was 1.4 : 1. The highest incidence was in the age group of 2–5 years. The main causes were traffic injury and falls (35.7% for each), followed by home injuries (21%) and sport-related injuries (7%). Regarding the severity of injury, 81% of children had mild injury, 13% had moderate injury, and 6% had severe injury. Concussion was the commonest type of head injury (56%), followed by skull fractures (23%). The functional outcome was assessed at the time of discharge, and 3 months later. Good recovery was achieved in 91% of children; moderate disability was present in 7% of children; and less than 2% of children showed sustained severe disability.
CONCLUSION: Children aged 5 years or less comprised 75% of children who presented to the hospital following head injury. Falls and road traffic accidents were the commonest causes of injury. Most injuries were of mild severity, and concussion was the commonest encountered type of injury. Assessment of functional outcome showed good recovery in most children. Enforcement of strict effective regulations and observing safety measures during driving by authorities is needed to reduce traffic accidents. Health education programs for parents about careful supervision and first aid should be provided to help prevent child head injury and its disastrous consequencest.