Penetrating head injuries in children presenting to the emergency department in Australia and New Zealand: A PREDICT prospective study

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dc.contributor.authorBabl, F.E.
dc.contributor.authorLyttle, M.D.
dc.contributor.authorBressan, S.
dc.contributor.authorBorland, M.L.
dc.contributor.authorPhillips, N.
dc.contributor.authorKochar, A.
dc.contributor.authorDalton, S.
dc.contributor.authorCheek, J.A.
dc.contributor.authorGilhotra, Y.
dc.contributor.authorFuryk, J.
dc.contributor.authorNeutze, J.
dc.contributor.authorDonath, S.
dc.contributor.authorHearps, S.
dc.contributor.authorArpone, M.
dc.contributor.authorCrowe, L.
dc.contributor.authorDalziel, S.R.
dc.contributor.authorBarker, R.
dc.contributor.authorOakley, E.
dc.date.issued2018
dc.description.abstractAim: Penetrating head injuries (pHIs) are associated with high morbidity and mortality. Data on pHIs in children outside North America are limited. We describe the mechanism of injuries, neuroimaging findings, neurosurgery and mortality for pHIs in Australia and New Zealand. Methods: This was a planned secondary analysis of a prospective observational study of children <18 years who presented with a head injury of any severity at any of 10 predominantly paediatric Australian/New Zealand emergency departments (EDs) between 2011 and 2014. We reviewed all cases where clinicians had clinically suspected pHI as well as all cases of clinically important traumatic brain injuries (death, neurosurgery, intubation >24 h, admission >2 days and abnormal computed tomography). Results: Of 20 137 evaluable patients with a head injury, 21 (0.1%) were identified to have sustained a pHI. All injuries were of non-intentional nature, and there were no gunshot wounds. The mechanisms of injuries varied from falls, animal attack, motor vehicle crashes and impact with objects. Mean Glasgow Coma Scale on ED arrival was 10; 10 (48%) had a history of loss of consciousness, and 7 (33%) children were intubated pre-hospital or in the ED. Fourteen (67%) children underwent neurosurgery, two (10%) craniofacial surgery, and five (24%) were treated conservatively; four (19%) patients died. Conclusions: Paediatric pHIs are very rare in EDs in Australia and New Zealand but are associated with high morbidity and mortality. The absence of firearm-related injuries compared to North America is striking and may reflect Australian and New Zealand firearm regulations.
dc.description.statementofresponsibilityFranz E Babl, Mark D Lyttle, Silvia Bressan, Meredith L Borland, Natalie Phillips, Amit Kochar, Sarah Dalton, John A Cheek, Yuri Gilhotra, Jeremy Furyk, Jocelyn Neutze, Susan Donath, Stephen Hearps, Marta Arpone, Louise Crowe, Stuart R Dalziel, Ruth Barker and Ed Oakley
dc.identifier.citationJournal of Paediatrics and Child Health, 2018; 54(8):861-865
dc.identifier.doi10.1111/jpc.13903
dc.identifier.issn1034-4810
dc.identifier.issn1440-1754
dc.identifier.urihttp://hdl.handle.net/2440/114188
dc.language.isoen
dc.publisherWiley
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/1046727
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/1058560
dc.rights© 2018 Paediatrics and Child Health Division (The Royal Australasian College of Physicians)
dc.source.urihttps://doi.org/10.1111/jpc.13903
dc.subjectAustralia
dc.subjectchild
dc.subjectfirearm injuries
dc.subjecthead injury
dc.subjectNew Zealand
dc.titlePenetrating head injuries in children presenting to the emergency department in Australia and New Zealand: A PREDICT prospective study
dc.typeJournal article
pubs.publication-statusPublished

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