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Observational Study
. 2025 Sep 23;9(1):e003767.
doi: 10.1136/bmjpo-2025-003767.

Reduced hospitalisations for paediatric mild traumatic brain injury: a nationwide observational study

Nora Bruns  1 , Rayan Hojeij  2 , Pia Brensing  2 , Oliver Andres  3 , Christian von Schnakenburg  4 , Catharina Anna Neumann  5 , Eric Waltersbacher  6 , Hendrik Juenger  7 , Martin Grieser  8 , Sebastian Gaus  9 , Thomas Lücke  10 , Friedrich Reichert  11 , Jan Beime  12 , Vera Schellerer  13 , Andreas Leutner  14 , Anna-Lisa Oechsle  15 , Johannes Meyer  16 , Alexandra Fröba-Pohl  17 , Johanna Wagner  18 , Viviane Klingmann  19 , Karl F Schettler  20 , Matthias Keller  21 , Ursula Felderhoff-Mueser  2 , Christian Dohna-Schwake  2 , Florian Heinen  18 , Michaela Bonfert  18
Affiliations
Observational Study

Reduced hospitalisations for paediatric mild traumatic brain injury: a nationwide observational study

Nora Bruns et al. BMJ Paediatr Open. .

Abstract

Objective: Traumatic brain injury (TBI) is common in childhood, with mild TBI (mTBI) predominating. Germany reports higher hospitalisation rates for paediatric TBI than any other country, suggesting overadmission of mild cases. The study objective was to determine TBI-related hospitalisations in patients <18 years from 2014 to 2020 and describe variability of TBI-related hospitalisations between emergency departments (EDs) VSports手机版. .

Design: Retrospective observational study using the German hospital dataset (GHD) and controlling data from 18 paediatric EDs. V体育安卓版.

Setting: Cases were identified from the GHD using International Classification of Diseases-10 codes and classified by severity using the Abbreviated Injury Scale for the head V体育ios版. Additionally, the proportion of inpatient versus outpatient TBI management from 18 paediatric EDs was assessed. .

Patients: Cases with TBI as discharge diagnosis hospitalised in Germany (GHD) or presenting at a participating ED. VSports最新版本.

Interventions: N/A. V体育平台登录.

Main outcome measures: Standardised morbidity ratios (SMRs) for 2020 with 2014-2019 as reference period (GHD); proportion of hospitalisations of TBI patients per ED VSports注册入口. .

Results: Among 618 577 TBI cases, mean annual TBI hospitalisations declined from 91 299±1656 (mean±SD) cases in 2014-2019 to 70 783 in 2020 V体育官网入口. SMRs for all-cause admissions (0. 83 (95% CI 0. 81 to 0. 85)) and mTBI (0. 75 (95% CI 0. 73 to 0. 78)) decreased more strongly than for moderate and severe TBI (0. 95 (95% CI 0. 91 to 0. 99) and 0. 95 (95% CI 0. 90 to 1. 01)). Hospitalisation rates in EDs ranged from 19. 1% to 93. 0% (median: 75. 0%). .

Conclusions and relevance: The disproportionate reduction of mTBI hospitalisations during the COVID-19 pandemic compared with moderate to severe cases suggests that there is potential for safely managing more mild cases in outpatient settings. VSports在线直播.

Keywords: Child Health.

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"VSports手机版" Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1. (a) Annual paediatric hospital admissions for mild TBI (light grey) and moderate to severe TBI (dark grey) in Germany 2014–2020. Dashed line: Average annual admissions 2014–2020. (b) Standardised morbidity ratios (SMR) for all-cause and TBI-related paediatric hospital admissions in Germany 2014–2020. Reference period: 2014–2019, observation period: 2020. AIS, Abbreviated Injury Scale; TBI, traumatic brain injury.
Figure 2
Figure 2. Percentages of hospital admissions (grey) versus outpatient management (green) of paediatric patients with mild TBI among 18 German paediatric emergency departments in 2022. TBI, traumatic brain injury.
See this image and copyright information in PMC

References

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    1. Dewan MC, Mummareddy N, Wellons JC, 3rd, et al. Epidemiology of Global Pediatric Traumatic Brain Injury: Qualitative Review. World Neurosurg. 2016;91:497–509. doi: 10.1016/j.wneu.2016.03.045. - DOI - PubMed
    1. Falkai P, Schara-Schmidt U. The german brain plan. 2022. [13-Jan-2025]. "VSports注册入口" https://braincouncil.de/images/2022/download/German-Brain-Plan-online-Au... Available. Accessed.
    1. Bruns N, Trocchi P, Felderhoff-Müser U, et al. Hospitalization and Morbidity Rates After Pediatric Traumatic Brain Injury: A Nation-Wide Population-Based Analysis. Front Pediatr. 2021;9:747743. doi: 10.3389/fped.2021.747743. - DOI - PMC - PubMed

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