Pediatric Traumatic Brain Injury

Incidence of pediatric TBI refers to the number of new cases identified in a specified time period. Prevalence of TBI refers to the number of children who are living with the condition in a given time period.

Incidence and prevalence rates of pediatric TBI vary across clinical and epidemiological studies. These variations are often due to differences in participant characteristics (e.g., ages included), diagnostic classification criteria within and across subtypes (e.g., mTBI vs. severe TBI), and sources of data (e.g., hospital admissions, emergency room visits, general practitioner visits). Moreover, current statistics do not take into account children and adolescents who do not seek medical care. Therefore, these estimates may significantly underestimate the incidence and prevalence of pediatric TBI.

Regardless of variations, TBI is the leading cause of disability and death in children ages 0–4 years and adolescents ages 15–19 years (CDC, 2015). Also, it is estimated that 145,000 children and adolescents (ages 0–19 years) are living with lasting cognitive, physical, or behavioral effects of TBI (Zaloshnja, Miller, Langlois, & Selassie, 2008).

General Statistics

  • In the United States, approximately half a million children ages 0–14 years (n = 473,947) are admitted to emergency rooms each year as a result of a TBI (Faul, Xu, Wald, & Coronado, 2010). The estimated annual number for TBI-related emergency room visits, hospitalizations, and deaths combined was 511,257 for this same age range (Faul et al., 2010).
  • A review by Thurman (2016) reported a median estimated incidence of TBI of 691 per 100,000 children (0–24 years) annually based on U.S. emergency room visits.
  • A review examining worldwide incidence rates of pediatric TBI revealed variations by country ranging from 47 to 280 per 100,000 children. Rates of hospital admission vary widely and are higher in the United States than in other countries (Dewan, Mummareddy, Wellons, & Bonfield, 2016).

Age

  • In the United States, children ages 0–4 years had the highest estimated annual rates of TBI-related emergency room visits (1,256 per 100,000), followed by adolescents ages 15–19 years of age (757 per 100,000; Faul et al., 2010). These same trends were noted in a population-based study using combined data from emergency room visits, hospitalizations, and death (Koepsell et al., 2011).

Gender

  • Across all age groups, the incidence rates of TBI are higher in boys than in girls (Faul et al., 2010; Keenan & Bratton, 2006; Langlois, Rutland-Brown, & Wald, 2006; Thurman, 2016). Based on combined data from emergency room visits, hospitalizations, and death, boys ages 0–4 years had the highest incidence rates of TBI (Faul et al., 2010).
  • Thurman (2016) reported that boys (0–9 years) were 1.4 times more likely than girls to have a TBI. The male-to-female ratio increased to 2.2 for older children and young adults (10–20 years).
  • Although the overall rates of TBI are generally higher in boys than in girls, the incidence of mTBI is on the rise for girls (Lincoln et al., 2011). In high school and collegiate athletics, girls have higher concussion rates than boys in sports played by both sexes (Covassin, Moran, & Elbin, 2016; Dick, 2009; Hootman, Dick, & Agel, 2007; Marar, McIlvain, Fields, & Comstock, 2012).

Severity

  • Approximately 80% of TBI across the lifespan is categorized as mTBI (Bazarian et al., 2005; CDC, 2003; Wortzel & Granacher, 2015). These same trends are reported in children with mTBI occurring in 692 of 100,000 children aged 0–15 years (Guerrero, Thurman, & Sniezek, 2000) and in 296 of 100,000 children aged 0–17 years (Koepsell et al., 2011). Koepsell et al. (2011) reported lower incidence rates for moderate, severe, or fatal TBIs (0.8 per 100,000 children). Within this same group, the incidence rates were highest for children (aged 15–17 years). A study examining causes and trends of TBI-related hospitalizations in adolescents in the United States (n = 139,798) revealed that 46% of patients were categorized as mild, 38% as moderate, and 16% as severe (Asemota, George, Bowman, Haider, & Schneider, 2013).
  • Each year, approximately 1 in 220 children are seen in emergency rooms as a result of a concussion (Meehan & Mannix, 2010).

Content Disclaimer: The Practice Portal, ASHA policy documents, and guidelines contain information for use in all settings; however, members must consider all applicable local, state and federal requirements when applying the information in their specific work setting.