International Multicenter Study of Head Injury in Children

With the object of evaluating different epidemiological factors in the acut e phase of head injury (HI) in the pediatric age group in five countries (A rgentina, Brazil, France, Hong-Kong and Spain), we carried out a prospectiv e and descriptive study, in which we analyzed the clinical and radiological risk factors versus management and outcome 7-30 days after trauma. We incl uded all children seen in the emergency department and hospitalized who wer e aged between 0 and 15 years and had sustained HI. Data were compiled from the clinical records and analyzed for neurological evaluation with the Gla sgow Coma Scale (GCS) and the Glasgow Paediatric Coma Score (GPCS), and als o by means of dynamics, symptoms, skull X-rays, CT scans. The total of 2478 patients enrolled in the study was made up of 60.9% boys and 39.1% girls. Age distribution was as follows: 55.2% aged 0-4 years; 28.3% aged 5-9 years , and 16.4% aged 10-15 years. Most (75.3%, or 1768) of these patients compl eted follow-up. The total sample included 1058 children (42.7%) who require d hospitalization. Skull fractures were identified in 11.8% (298) of the ca ses, and 6.4% (158) of CT scans were pathologic. Minor HI accounted for 56. 4% of these children, moderate HI for 38.9%, and severe HI for the remainin g 4.7%. The lethality rate was 1.6%. Our preliminary data reveal that it is very important for new guidelines on the treatment of minor HI to be prepa red, because patients with minor HI had undergone the most skull X-rays and also most frequently been admitted to hospital for unnecessarily long peri ods of time, though the incidence of brain damage (1.6%) was lowest in this group of the study population. We intend to carry out a full analysis of t he various risk factors at the end of the study.