Predicting Patients at Risk for Prolonged Hospital Stays Following Pediatrics Traumatic Head Injuries in High-income Developing Country: A Retrospective Cohort Study

Introduction: Traumatic brain injuries (TBIs) in pediatrics are the most common cause of long-term morbidity and mortality, generating a considerable burden on the healthcare system. In the current retrospective study, we aimed to identify predictors contributing to prolonged hospital stays in pediatric TBI.

Methods: A retrospective cohort study included all pediatric cases (age younger than 14) who presented to Khoula Hospital with TBI and were seen from January 2015 to December 2019. The multivariate binary logistic regression analysis has been used to determine the independent predictors of prolonged hospital stay. Prolonged hospitalization was defined as mean ± 2 standard deviation days.

Results: A total of 866 cases of pediatric TBI were documented. The mean age was 4.33 years. The length of hospital stay ranged from < 1 day to 90 days (mean = 3.65, standard deviation = 6.84). Prolonged hospitalization was calculated to be >17 days. Thirty-one patients had prolonged hospital stay out of the studied cohort, with an incidence proportion of prolonged stay = 3.6% (95% CI = 2.4%−5.0%). Prolonged hospitalizations were associated with motor vehicle collision injuries (odds ratio [OR]: 27.028, 95% confidence interval [CI] = 2.744–266.194, P = 0.005); pedestrian injuries (OR = 11.667, 95% CI = 1.017–133.805, P = 0.048), and Glasgow Coma Scale score on arrival of < 9 (OR = 8.149, 95% CI = 1.167–56.921, P = 0.034).

Conclusion : The current study identified motor vehicle collision and pedestrian injuries, as well as initial Glasgow Coma Scale score of < 9 as independent predictors of prolonged hospitalization in pediatrics TBI.