All-cause mortality and suicide after pediatric traumatic brain injury: a 20-year nationwide study in Finland.

Autor: Möttönen J; Tampere University, Faculty of Medicine and Life Sciences, Tampere, Finland. Electronic address: julius.mottonen@tuni.fi., Ponkilainen VT; Department of Orthopedics and Traumatology, Tampere University Hospital, Tampere, Finland., Iverson GL; Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, USA; Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, MA, United States; Department of Physical Medicine and Rehabilitation, Schoen Adams Research Institute at Spaulding Rehabilitation, Charlestown, MA, United States; Sports Concussion Program, Mass General for Children, Boston, MA, United States., Cassidy JD; Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Ontario, Canada., Luoto T; Department of Neurosurgery, Tampere University Hospital, Tampere, Finland., Mattila VM; Tampere University, Faculty of Medicine and Life Sciences, Tampere, Finland; Department of Orthopedics and Traumatology, Tampere University Hospital, Tampere, Finland., Kuitunen I; Department of Pediatrics, Kuopio University Hospital, Kuopio, Finland; Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.
Jazyk: angličtina
Zdroj: Public health [Public Health] 2024 Nov; Vol. 236, pp. 125-132. Date of Electronic Publication: 2024 Aug 24.
DOI: 10.1016/j.puhe.2024.07.025
Abstrakt: Objectives: To assess all-cause mortality and suicides after pediatric traumatic brain injury (pTBI).
Study Design: We conducted population-based historical cohort study using three nationwide registers from 1998 to 2018 in Finland. All patients that were the age of 0-17 at the time of the pTBI were included. The reference group consisted of children with ankle or wrist fractures. We used Kaplan-Meier and restricted mean survival time (RMST) analysis with 95% confidence intervals (CI) to compare all-cause mortality and suicides between groups.
Results: After 20 years of follow-up, there were 479 deaths in the pTBI group (0.67% of 71,963) and 306 deaths in the reference group (0.47% of 64,848). In the pTBI group, 28.6% of the deaths occurred after the first follow-up year, compared to 2.6% in the reference group. In all-cause mortality, survival time was slightly less in the pTBI group with age and gender adjustment throughout the follow-up period [20-year RMST ratio: 0.995; CI (0.994-0.996)]. The leading manners of death were suicides (pTBI group = 28.4%; reference group = 45.5%) and traffic collisions (pTBI group = 37.4%; reference group = 20.8%). Age and gender-adjusted survival time was slightly less for those with suicide as a manner of death in the pTBI group [10-year RMST ratio: 0.999; CI (0.999-0.999); 20-year RMST ratio: 0.999; CI (0.998-0.999)].
Conclusions: Children and adolescents who sustained a TBI have slightly lower long-term survival time for all-cause mortality, most of which occurs during the first year following injury. There is no clinically meaningful difference in deaths by suicide between the two injury groups.
(Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Databáze: MEDLINE
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