title: Pediatric TBI in Finland: An examination of hospital discharges (1998-2012).
abstract: BACKGROUND
  Traumatic brain injury constitutes a persistent health problem among pediatric populations worldwide and is often referred to as a silent epidemic. There remains a paucity of scientific exploration with regard to understanding the ecological risk profiles of well-defined populations. In Finland, the healthcare system covers all hospitals, provides uniform access to care and has a universal surveillance system that allows for epidemiological examination of a wide variety of health issues. The present study aims to clarify the incidence, type and geographical presentation of pediatric TBI in Finland.
  
  
  METHODS
  We utilized the National Hospital Discharge Register (NHDR) to prospectively identify all new cases of TBI among persons aged 18 years or younger between 1998 and 2012. Incidence rates were computed as average annual rates per 100,000 person years (py).
  
  
  RESULTS
  During the study period 1998-2012, 21,457 children and adolescents were hospitalized for TBI. The cumulative incidence rate for the entire period was 99/100,000. Males were approximatively 1.5 times more likely to have sustained a TBI and had consistently higher rates during each year under study. Concussions were the most common form of TBI (92.9/100,000 person years), with diffuse brain injuries being the second most common (8.7/100,000 py). Diagnostic trends differed markedly with southern Finland experiencing the lowest rates of TBI when adjusted for population size.
  
  
  CONCLUSIONS
  TBI are serious and potentially disabling conditions. The elevated levels of pediatric TBI in Finland warrant increased attention.
authors.affiliation: Turku University Hospital, Department of Adolescent Psychiatry, University of Turku, Kaivokatu 18 A, 4th Floor, 20520 Turku, Finland; Centre for Injury Prevention and Community Safety, PeerCorps Trust Fund, 352/64 Makunganya Street, Co-Architecture Building, 4th Floor, P.O. Box 22499, Dar es Salaam, Tanzania. Electronic address: michael.l.wilson@utu.fi.
authors.forename: Michael
authors.initials: M
authors.lastname: L Wilson
authors.affiliation: Division of Clinical Neurosciences, Department of Rehabilitation and Brain Trauma, Turku University Hospital, Turku University, Turku, Finland.
authors.forename: Olli
authors.initials: O
authors.lastname: Tenovuo
authors.affiliation: Department of Orthopaedics, Tampere University Hospital Tampere, Finland; Department of Clinical Science, Intervention and Technology (CLINTEC), Division of Orthopedics and Biotechnology, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Ville M
authors.initials: VM
authors.lastname: Mattila
authors.affiliation: THL National Institute for Health and Welfare, P.O. Box 30, 00271 Helsinki, Finland; Karolinska: Department of Neurobiology, Care Sciences and Society (NVS), SE-171 77 Stockholm, Sweden.
authors.forename: Mika
authors.initials: M
authors.lastname: Gissler
authors.affiliation: Centre for Injury Prevention and Community Safety, PeerCorps Trust Fund, 352/64 Makunganya Street, Co-Architecture Building, 4th Floor, P.O. Box 22499, Dar es Salaam, Tanzania.
authors.forename: Karen L
authors.initials: KL
authors.lastname: Celedonia
authors.affiliation: THL National Institute for Health and Welfare, P.O. Box 30, 00271 Helsinki, Finland.
authors.forename: Antti
authors.initials: A
authors.lastname: Impinen
authors.affiliation: Turku University Hospital, Department of Adolescent Psychiatry, University of Turku, Kaivokatu 18 A, 4th Floor, 20520 Turku, Finland.
authors.forename: Simo
authors.initials: S
authors.lastname: Saarijärvi
mesh_terms: D000293:Adolescent; D000367:Age Factors; D000070642:Brain Injuries, Traumatic / Q000175:diagnosis / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005387:Finland / Q000453:epidemiology; D062306:Geography, Medical; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D063886:Patient Discharge Summaries / Q000706:statistics & numerical data*; D012042:Registries; D012737:Sex Factors
keywords: Adolescent; Epidemiology; Pediatric; Surveillance; TBI