Cost of pediatric traumatic brain injury in developing countries: a retrospective cohort study.

Abstract

Introduction: Traumatic brain injury (TBI) is a known health burden worldwide; however, no literature is available on its economic burden in developing countries, this study aims to highlight the cost of pediatric TBI and compare mild, moderate, and severe cases.

Methods: A retrospective study was conducted in the neurosurgery department of a tertiary hospital in a developing country. Data on pediatric cases presenting with TBI from January 2015 to December 2019 was collected from electronic medical records; this included patients' demographics, neuro-vital signs, mechanism of TBI, intervention, diagnosis on imaging, investigations, medications, duration of hospital and intensive care unit stay. Costs of interventions, investigations, and hospital stay were retrieved from the hospital finance division, total costs were calculated, and analysis was done to compare the relation of age, diagnosis, mechanism of injury, and intervention to total cost.

Results: The sample included 921 cases (M: F, 1.7:1), with 67.1% aged less than 5 years. Falls and motor vehicle collisions had the highest total costs. Cases with normal radiological findings and skull fractures constituted 35.9% and 30.2%, respectively, and consequently had the highest costs; epidural hematoma followed in highest costs. TBI severity, surgical intervention, age < 5 years old, and longer hospital stays were significantly associated with higher total costs (P < 0.001).

Conclusions: Pediatric TBI is a health and economic burden, most notably in children less than 5 years old and those with severe injuries. Programs advocating children's safety and hospital guidelines for the diagnosis and appropriate timely management need to be implemented.