Severity of Mild Head Trauma in the Pediatric Population: Comparison between patients younger or older than two years. Real Life of Trauma Center 2 Level

Background: Head injuries represent one of the most important causes of morbidity and mortality in pediatric age. In literature it appears that between one and five years, road accidents represent 9% of mortality, between five and fourteen years they represent 22%.

Objective: Compare the population aged less than 2 years versus those aged 2 years or older.

Methods: We enrolled patients aged ≤ 14 who are consecutively referred to our emergency room from January 1st to December 31st 2018.

Results: We enrolled 702 patients. 250 under 2 years of age and 452 over 2 years of age. Patients over 2 years of age more frequently came with their own vehicle (89.1 vs 87.6), the remainder accompanied by the territorial emergency service (118 in Italy, equivalent to American 911). Patients under the age of 2 more frequently had a domestic accident as the cause, while the older patients were more represented by sports, school and road accidents. More frequently, older patients have a low priority code at the doctor`s visit (99.5% vs 98.4%) and require medium or high intensity of care (0.4 % vs 0.2%). They ware discharged more frequently (98.9 % vs 95.2 %) and a lower percentage was hospitalized for observation. A lower percentage of older patients had a high (yellow or red) severity code at discharge (0% vs 0.9%). The average waiting times for the medical examination were shorter for the younger population (30 min vs 48 min), instead it is similar the hospital stay in the emergency room (118 min vs 111 min). The number of re-visits is substantially overlapping.

Conclusion: Patients present overall low developmental risk and few complications. However, younger patients more frequently need medical observation, admission to the pediatric observation ward, or have high severity codes at discharge