Table_2_Hospitalization and Morbidity Rates After Pediatric Traumatic Brain Injury: A Nation-Wide Population-Based Analysis.docx

Background: Even though traumatic brain injury (TBI) is a major cause of morbidity and mortality in children around the globe, population-based and nation-wide data to assess the burden of TBI is scarce.
Methods:Based on diagnosis related groups from nation-wide hospital data, we extracted data on all TBI-related hospitalizations in children <18 years in Germany between 2014 and 2018. We calculated crude, age-specific and standardized incidence rates for hospitalizations, imaging, intracranial injury, neurosurgery, and mortality.
Results:Out of 10.2 million hospitalizations, we identified 458,844 cases with TBI as primary or secondary diagnosis, resulting in a crude incidence rate of 687/100,000 child years (CY). Age-specific rates of computed tomography were below 30/100,000 CY until the age of 10 years and increased to 162/100,000 CY until 17 years of age. Intracranial injury was diagnosed in 2.7%, neurosurgery was performed in 0.7% of patients, and 0.7% were mechanically ventilated. Mortality was 0.67/100,000 CY (0.1%).
Conclusions:Despite substantial hospitalization rates for pediatric TBI in Germany, the rates of imaging, the need for mechanical ventilation, neurosurgery and mortality were overall very low. Reasons for hospitalization and measures to reduce unnecessary admissions warrant further investigation.

背景：尽管创伤性脑损伤（traumatic brain injury, TBI）是全球范围内儿童发病与死亡的主要诱因之一，但目前用于评估TBI疾病负担的基于人群的全国性数据仍较为匮乏。
方法：本研究基于全国住院患者诊断相关分组（diagnosis related groups）数据，提取了2014至2018年德国所有18岁以下儿童的TBI相关住院病例数据，并计算了住院、影像学检查、颅内损伤、神经外科手术及死亡的粗发病率、年龄别发病率和标准化发病率。
结果：在1020万例住院病例中，本研究共确认458844例以TBI为主要或次要诊断的病例，粗发病率为687/10万儿童人年（child years, CY）。10岁以下儿童的计算机断层扫描（computed tomography）年龄别发病率低于30/10万儿童人年（CY），至17岁时升至162/10万儿童人年（CY）。2.7%的患者被诊断为颅内损伤，0.7%的患者接受了神经外科手术，0.7%的患者接受了机械通气。总体死亡率为0.67/10万儿童人年（CY）（0.1%）。
结论：尽管德国儿童TBI的住院率较高，但影像学检查率、机械通气需求、神经外科手术率及总体死亡率均处于较低水平。关于儿童TBI住院的诱因及减少非必要住院的干预措施，仍有待进一步研究。