Incidence and mortality of moderate and severe traumatic brain injury in children: A ten year population-based cohort study in Norway

Objective: In this study we wanted to estimate population-based rates of incidence and mortality of moderate and severe traumatic brain injury (TBI) in children in one specific region in Norway. Methods: In the region there are seven acute care hospitals (ACHs) in addition to a Level 1 trauma centre. Of 702 869 inhabitants (2014), 145 395 were children aged 0-16 years. Data were collected during ten years (2004-2014). All children aged 0-16 years with moderate (Glasgow Coma Scale [GCS] score 9-13) or severe (GCS score <= 8) TBI admitted to the Level 1 trauma centre were prospectively included. Children treated outside the Level 1 trauma centre were retrospectively included from the ACHs. Children who died from TBI pre-hospitally were included from the National Cause of Death Registry. Poisson regression was used to estimate incidence rate ratios (with a 95% confidence interval) comparing age, sex, and time periods. Results: A total of 71 children with moderate or severe TBI were identified. Crude incidence rates were 2.4 (95% CI 1.7-3.3) for moderate and 2.5 (95% CI 1.8-3.4) for severe TBI per 100 000 person-years (py). Mortality rate from TBI was 1.2 (95% CI 0.7-1-9) per 100 000 py, and 88% were prehospital deaths. Conclusion: The incidence rates and mortality of moderate and severe TBI were low compared to international reports. Most likely explained by successful national prevention of TBI. (C) 2019 The Authors. Published by Elsevier Ltd on behalf of European Paediatric Neurology Society.