title: Children and youth with non-traumatic brain injury: a population based perspective.
abstract: BACKGROUND
  Children and youth with non-traumatic brain injury (nTBI) are often overlooked in regard to the need for post-injury health services. This study provided population-based data on their burden on healthcare services, including data by subtypes of nTBI, to provide the foundation for future research to inform resource allocation and healthcare planning for this population.
  
  
  METHODS
  A retrospective cohort study design was used. Children and youth with nTBI in population-based healthcare data were identified using International Classification of Diseases Version 10 codes. The rate of nTBI episodes of care, demographic and clinical characteristics, and discharge destinations from acute care and by type of nTBI were identified.
  
  
  RESULTS
  The rate of pediatric nTBI episodes of care was 82.3 per 100,000 (N = 17,977); the average stay in acute care was 13.4 days (SD = 25.6 days) and 35% were in intensive care units. Approximately 15% were transferred to another inpatient setting and 6% died in acute care. By subtypes of nTBI, the highest rates were among those with a diagnosis of toxic effect of substances (22.7 per 100,000), brain tumours (18.4 per 100,000), and meningitis (15.4 per 100,000). Clinical characteristics and discharge destinations from the acute care setting varied by subtype of nTBI; the proportion of patients that spent at least one day in intensive care units and the proportion discharged home ranged from 25.9% to 58.2% and from 50.6% to 76.4%, respectively.
  
  
  CONCLUSIONS
  Children and youth with nTBI currently put an increased demand on the healthcare system. Active surveillance of and in-depth research on nTBI, including subtypes of nTBI, is needed to ensure that timely, appropriate, and targeted care is available for this pediatric population.
authors.affiliation: Toronto Rehabilitation Institute, University Health Network, 550 University Avenue, Toronto, ON, M5G 2A2, Canada. vincy.chan@uhn.ca.|Rehabilitation Sciences Institute, University of Toronto, 500 University Avenue, Toronto, ON, M5G 1 V7, Canada. vincy.chan@uhn.ca.|Pediatric Oncology Group of Ontario, 480 University Avenue, Toronto, ON, M5G 1 V2, Canada. vincy.chan@uhn.ca.
authors.forename: Vincy
authors.initials: V
authors.lastname: Chan
authors.affiliation: Pediatric Oncology Group of Ontario, 480 University Avenue, Toronto, ON, M5G 1 V2, Canada.|Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON, M5T 3 M7, Canada.
authors.forename: Jason D
authors.initials: JD
authors.lastname: Pole
authors.affiliation: Rehabilitation Sciences Institute, University of Toronto, 500 University Avenue, Toronto, ON, M5G 1 V7, Canada.|Holland Bloorview Kids Rehabilitation Hospital, 150 Kilgour Road, Toronto, ON, M5G 1R8, Canada.
authors.forename: Michelle
authors.initials: M
authors.lastname: Keightley
authors.affiliation: Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON, M5T 3 M7, Canada.|Centre for Addiction and Mental Health, 33 Russell Street, Toronto, ON, M5S 3M1, Canada.
authors.forename: Robert E
authors.initials: RE
authors.lastname: Mann
authors.affiliation: Toronto Rehabilitation Institute, University Health Network, 550 University Avenue, Toronto, ON, M5G 2A2, Canada.|Rehabilitation Sciences Institute, University of Toronto, 500 University Avenue, Toronto, ON, M5G 1 V7, Canada.|Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON, M5T 3 M7, Canada.
authors.forename: Angela
authors.initials: A
authors.lastname: Colantonio
mesh_terms: D000293:Adolescent; D001930:Brain Injuries / Q000453:epidemiology*; D001932:Brain Neoplasms / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007297:Inpatients; D008297:Male; D010351:Patient Discharge; D012189:Retrospective Studies; D055815:Young Adult
keywords: International Classification of Diseases; Non-traumatic brain injury; Pediatrics