Current incidence and management of children with traumatic head injuries: the Stockholm experience.
OBJECTIVE
A traumatic head injury is one of the most common causes of morbidity and mortality among children, however few population-based studies in this area have been reported. Therefore, the aim of this study was to evaluate the incidence and management of traumatic head injuries in children at a level-one trauma centre in Stockholm, Sweden.


METHODS
All children (n = 3168) who visited the emergency department with a history of head injury during 1 year were included.


METHODS
The required information was collected retrospectively and the children's medical records were reviewed.


RESULTS
The overall incidences of head injury were 865 per 100 000 children with the highest incidence (2379/10(5) children) occurring among children younger than 18 months of age. Twelve per cent (n = 396) were admitted to a hospital ward and CT scans were performed in 13% (n = 412) of all children. During this year, 0.3% required a neurosurgical intervention and only 1% of all children had documentation of a planned follow-up appointment.


CONCLUSIONS
The findings indicate that clinical documentation as a part of the early management in children with a head injury is inconsistent and suffers from lack of valid criteria. Implementation of clinical guidelines during emergency care would help improve subsequent hospital care, as well as the planning of health care services for these children.
Falk
Ann-Charlotte
AC
Department of Women and Child Health-Neuropediatrics, Astrid Lindgren's Hospital for Children, Karolinska Institut, Stockholm, Sweden. ann-charlotte.falk@karolinska.se
Klang
B
B
Paavonen
E J
EJ
von Wendt
L
L
D000058:Accidental Falls / Q000706:statistics & numerical data; D000063:Accidents, Traffic / Q000706:statistics & numerical data; D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D006259:Craniocerebral Trauma / Q000453:epidemiology*; D004282:Documentation / Q000706:statistics & numerical data; D005500:Follow-Up Studies; D006757:Hospital Units / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007223:Infant; D019635:Neurosurgical Procedures / Q000706:statistics & numerical data; D010343:Patient Admission / Q000706:statistics & numerical data; D011159:Population Surveillance; D012189:Retrospective Studies; D013548:Sweden / Q000453:epidemiology; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data; D014474:Unconsciousness / Q000453:epidemiology