Epidemiology and Rehabilitation of Repetitive Traumatic Brain Injury in Children 0-17 years in Iceland from 2010-2021

Abstract

Background: Research suggests that pediatric repeated TBI is on the rise. Children who experience rTBIs display more severe symptoms, such as cognitive, physical, and sleep difficulties, compared to their peers who sustained one or no TBI. There is no research on this topic in Iceland to date. This study aims to provide an overview of the rehabilitation services available to children and adolescents with rTBI in Iceland, to better understand the issue and identify potential intervention measures. Methods: A retrospective analysis of electronic medical records (2010-2021) for children aged 0-17 with rTBI was conducted. Data included demographics, visit frequency and duration, rehabilitation, causes, diagnosis, and injury severity score. Descriptive statistics were calculated for the cases identified through registered ICD-10 diagnosis. Results: The study involved 933 visits, with 59.4% being male and seeking rehabilitation more frequently. The average annual rate of rTBI was 85 per 100,000 children, peaking in 2018. Revisits averaged 2.2, with a mean gap of 1.5 years between each visit. 22% of the sample sought rehabilitation at Landspítali, with mental health being the most common diagnosis. Falls were the primary cause of the first two visits, while accidents were responsible for the subsequent visits. Concussion was the most common ICD-10 diagnosis in all visits (88.1%), with 97.9% of injuries classified as moderate. Conclusions: Our study found that 427 children in Iceland sought emergency care for rTBI, with some experiencing multiple TBI incidents. These findings highlight the prevalence of rTBI in the country. However, only a small fraction of these children received rehabilitation services at Landspítali. It is clear that an established pediatric TBI rehabilitation program is necessary, one that encompasses both acute care and long-term support services. Additional research on outpatient clinic visits and the consequences of rTBI in Iceland's children is needed to gain a more comprehensive understanding of this issue.