A profile of children with traumatic brain injury admitted to the Red Cross War Memorial Children?s Hospital Paediatric Intensive Care Unit in Cape Town, South Africa, between 2015 and 2019

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dc.contributor.advisorSalie, Mogamat
dc.contributor.advisorFigaji Anthony
dc.contributor.authorDu Plooy, Elri
dc.date.accessioned2024-04-18T12:54:04Z
dc.date.available2024-04-18T12:54:04Z
dc.date.issued2023
dc.date.updated2024-04-18T12:33:54Z
dc.description.abstractA Profile of Children with Traumatic Brain Injury Admitted to the Red Cross War Memorial Children's Hospital Paediatric Intensive Care Unit in Cape Town, South Africa, between 2015 and 2019 Background: Paediatric traumatic brain injury (TBI) is a public health problem with high morbidity and mortality. Objectives: We aim to highlight risk factors and describe associated morbidity and mortality of children admitted to our Paediatric Intensive Care Unit (PICU) at Red Cross War Memorial Children's Hospital in Cape Town. Methods: We retrospectively documented the hospitalization of all children with TBI admitted into our PICU between 2015 and 2019. Results: Of 272 children identified, 232 were enrolled: 190 (81.9%) had severe TBI (Glasgow Coma Scale [GCS] ≤8), 32 (13.8%) moderate TBI (GCS 9-12) and 10 (4.3%) mild TBI (GCS ≥13). Median age was 6.5 (IQR 3.5-9) years; 144 (62.1%) were male. Motor vehicle accidents accounted for 77% (179) of injuries. Two hundred (86.2%) children were invasively ventilated for a median of 3.5 (IQR 1-7) days; 26 children (13%, n=200) had a failed extubation and 16/200 (8%) required tracheostomies. Ninety-eight children (42.2%) had intracranial pressure monitoring. Almost 30% (67/232) required vasopressor support. Approximately a third (83/232) developed trauma-related seizures; 25 children (10.8%) required a Thiopentone infusion and 9 children (3.9%) a decompressive craniectomy. Common complications were post-extubation stridor (29/200 [14.5%]), hemiparesis (20/232 [8.6%]) and diabetes insipidus (15/232 [6.5%]). Median PICU stay was 3 (IQR 1-8.3) days, and hospitalization 11 (IQR 5-20) days. Eighty- three (35.8%) children were transferred for further rehabilitation; 24 (10.3%) died. Conclusion: Despite marked improvement since the 1990's, children admitted to PICU with TBI had considerable morbidity and mortality. Enhanced primary preventative strategies, especially for motor vehicle accidents, are imperative to prevent TBI in children.
dc.identifier.apacitationDu Plooy, E. (2023). <i>ETD: A profile of children with traumatic brain injury admitted to the Red Cross War Memorial Children?s Hospital Paediatric Intensive Care Unit in Cape Town, South Africa, between 2015 and 2019</i>. (). ,Faculty of Health Sciences ,Department of Paediatrics and Child Health. Retrieved from http://hdl.handle.net/11427/39409en_ZA
dc.identifier.chicagocitationDu Plooy, Elri. <i>"ETD: A profile of children with traumatic brain injury admitted to the Red Cross War Memorial Children?s Hospital Paediatric Intensive Care Unit in Cape Town, South Africa, between 2015 and 2019."</i> ., ,Faculty of Health Sciences ,Department of Paediatrics and Child Health, 2023. http://hdl.handle.net/11427/39409en_ZA
dc.identifier.citationDu Plooy, E. 2023. ETD: A profile of children with traumatic brain injury admitted to the Red Cross War Memorial Children?s Hospital Paediatric Intensive Care Unit in Cape Town, South Africa, between 2015 and 2019. . ,Faculty of Health Sciences ,Department of Paediatrics and Child Health. http://hdl.handle.net/11427/39409en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - Du Plooy, Elri AB - A Profile of Children with Traumatic Brain Injury Admitted to the Red Cross War Memorial Children's Hospital Paediatric Intensive Care Unit in Cape Town, South Africa, between 2015 and 2019 Background: Paediatric traumatic brain injury (TBI) is a public health problem with high morbidity and mortality. Objectives: We aim to highlight risk factors and describe associated morbidity and mortality of children admitted to our Paediatric Intensive Care Unit (PICU) at Red Cross War Memorial Children's Hospital in Cape Town. Methods: We retrospectively documented the hospitalization of all children with TBI admitted into our PICU between 2015 and 2019. Results: Of 272 children identified, 232 were enrolled: 190 (81.9%) had severe TBI (Glasgow Coma Scale [GCS] ≤8), 32 (13.8%) moderate TBI (GCS 9-12) and 10 (4.3%) mild TBI (GCS ≥13). Median age was 6.5 (IQR 3.5-9) years; 144 (62.1%) were male. Motor vehicle accidents accounted for 77% (179) of injuries. Two hundred (86.2%) children were invasively ventilated for a median of 3.5 (IQR 1-7) days; 26 children (13%, n=200) had a failed extubation and 16/200 (8%) required tracheostomies. Ninety-eight children (42.2%) had intracranial pressure monitoring. Almost 30% (67/232) required vasopressor support. Approximately a third (83/232) developed trauma-related seizures; 25 children (10.8%) required a Thiopentone infusion and 9 children (3.9%) a decompressive craniectomy. Common complications were post-extubation stridor (29/200 [14.5%]), hemiparesis (20/232 [8.6%]) and diabetes insipidus (15/232 [6.5%]). Median PICU stay was 3 (IQR 1-8.3) days, and hospitalization 11 (IQR 5-20) days. Eighty- three (35.8%) children were transferred for further rehabilitation; 24 (10.3%) died. Conclusion: Despite marked improvement since the 1990's, children admitted to PICU with TBI had considerable morbidity and mortality. Enhanced primary preventative strategies, especially for motor vehicle accidents, are imperative to prevent TBI in children. DA - 2023 DB - OpenUCT DP - University of Cape Town KW - Paediatrics and Child Health LK - https://open.uct.ac.za PY - 2023 T1 - ETD: A profile of children with traumatic brain injury admitted to the Red Cross War Memorial Children?s Hospital Paediatric Intensive Care Unit in Cape Town, South Africa, between 2015 and 2019 TI - ETD: A profile of children with traumatic brain injury admitted to the Red Cross War Memorial Children?s Hospital Paediatric Intensive Care Unit in Cape Town, South Africa, between 2015 and 2019 UR - http://hdl.handle.net/11427/39409 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/39409
dc.identifier.vancouvercitationDu Plooy E. ETD: A profile of children with traumatic brain injury admitted to the Red Cross War Memorial Children?s Hospital Paediatric Intensive Care Unit in Cape Town, South Africa, between 2015 and 2019. []. ,Faculty of Health Sciences ,Department of Paediatrics and Child Health, 2023 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/39409en_ZA
dc.language.rfc3066eng
dc.publisher.departmentDepartment of Paediatrics and Child Health
dc.publisher.facultyFaculty of Health Sciences
dc.subjectPaediatrics and Child Health
dc.titleA profile of children with traumatic brain injury admitted to the Red Cross War Memorial Children?s Hospital Paediatric Intensive Care Unit in Cape Town, South Africa, between 2015 and 2019
dc.typeThesis / Dissertation
dc.type.qualificationlevelMasters
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