Urban ndash;rural differences in pediatric traumatic head injuries: A prospective nationwide study

Jonas G Halldorsson1, Kjell M Flekkoy2, Kristinn R Gudmundsson3, Gudmundur B Arnkelsson4, Eirikur Orn Arnarson1,51Psychological Health Services, Landspitali University Hospital, Reykjavik, Iceland; 2Department of Psychology, University of Oslo, Oslo, Norway; 3Department of Neurosurgery, Landspitali University Hospital, Reykjavik, Iceland; 4Faculty of Social Science, University of Iceland, Reykjavik, Iceland; 5Faculty of Medicine, University of Iceland, Reykjavik, IcelandAims: To estimate differences in the incidence of recorded traumatic head injuries by gender, age, severity, and geographical area.Methods: The study was prospective and nationwide. Data were collected from all hospitals, emergency units and healthcare centers in Iceland regarding all Icelandic children and adolescents 0–19 years old consecutively diagnosed with traumatic head injuries (N = 550) during a one-year period.Results: Annual incidence of minimal, mild, moderate/severe, and fatal head injuries (ICD-9 850–854) was 6.41 per 1000, with 95% confi dence interval (CI) 5.9, 7.0. Annual incidence of minimal head injuries (ICD-9 850) treated at emergency units was 4.65 (CI 4.2, 5.1) per 1000, mild head injuries admitted to hospital (ICD-9 850) was 1.50 (CI 1.3, 1.8) per 1000, and moderate/severe nonfatal injuries (ICD-9 851–854) was 0.21 (CI 0.1, 0.3) per 1000. Death rate was 0.05 (CI 0.0, 0.1) per 1000. Young children were at greater risk of sustaining minimal head injuries than older ones. Boys were at greater risk than girls were. In rural areas, incidence of recorded minimal head injuries was low.Conclusions: Use of nationwide estimate of the incidence of pediatric head injury shows important differences between urban and rural areas as well as between different age groups.Keywords: incidence, nationwide, pediatric, prospective, traumatic head injuries, urban-rural differences