Table 1.
Children’s characteristics stratified by early (time to DC ≤ 2 h) and late DC (> 2 h) after hospital admission for severe traumatic brain injury in Germany, 2016–2022.
| Total (N = 589), No.(%) |
Early DC (n = 323), No.(%) |
Late DC (n = 266), No. (%) |
|
|---|---|---|---|
| Age, median (IQR) | 12 (4–16) | 12 (3–16) | 11 (5–16) |
| Age categories | |||
| 0–5 | 171 (29.0) | 96 (29.7) | 75 (28.2) |
| 6–12 | 121 (20.5) | 60 (18.6) | 61 (22.9) |
| 13–17 | 297 (50.4) | 167 (51.7) | 130 (48.9) |
| Sex, male | 395 (67.1) | 220 (68.1) | 175 (65.8) |
| LOS in days, median (IQR) | 17 (5–29) | 11 (2–23) | 21.5 (9–32) |
| LOS in survivors, median (IQR)** | 22 (13–35) | 19 (11–33) | 24 (16–35) |
| Transferred cases | 50 (8.4) | 27 (8.3) | 23 (8.6) |
| In-hospital mortality | 163 (27.7) | 121 (37.5) | 42 (15.8) |
| 14-days In-hospital mortality, | 155 (26.3) | 116 (35.9) | 39 (14.7) |
|
Time to death after DC, median (IQR) |
2 (1–6) | 2 (1–4) | 4 (1–5) |
|
Mechanical ventilation (days), median (IQR)** |
7.5 (2.5–15.8) | 5 (1.7–12) | 10.8 (5.9–19) |
| Serious extracranial injuries (AIS ≥ 3) | |||
| Thorax | 195 (33.1) | 118 (36.5) | 77 (28.9) |
| Abdomen | 28 (4.7) | 21 (6.5) | 7(2.6) |
| Spine | 11 (1.9) | 6 (1.9) | 5 (1.8) |
| Type of head injury | |||
| EH (Epidural) | 166 (28.2) | 92 (28.5) | 74 (27.8) |
| SH (Subdural) | 411 (69.8) | 231 (71.5) | 180 (67.7) |
| SAH (Subarachnoid) | 223 (37.9) | 116 (35.9) | 107 (40.2) |
| Brain oedema | 382 (64.8) | 210 (65.0) | 172 (64.7) |
| Complications | |||
| IHCA | 67 (11.4) | 35 (10.8) | 32 (12.0) |
| OHCA | 20 (3.4) | 11 (3.4) | 9 (3.4) |
| Coma | 184 (31.2) | 112 (34.7) | 72 (27.1) |
| Seizure | 73 (12.4) | 34 (10.5) | 39 (14.7) |
| Epilepsy | 18 (3.0) | 5 (1.5) | 13 (4.9) |
| DIC | 30 (5.0) | 24 (7.4) | 6 (2.3) |
| PCCC in survivors, median (IQR)** | 2 (1–3) | 2 (1–2) | 2 (0–3) |
| Evacuation of hematoma | 373 (63.3) | 233 (72.1) | 140 (52.6) |
| EVD | 126 (21.4) | 56 (17.3) | 70 (26.3) |
| Preoperative | xx | xx | 41/70 (58.6) |
| Intraoperative | 48 (38.1) | 32/56 (57.1) | 16/70 (22.8) |
| Postoperative | xx | xx | 13/70 (18.6) |
| Time to EVD (days), median (IQR) | 3.5 (1–47) | 2 (1-29.5) | 13 (1–73) |
| ICP monitoring | 307 (52.1) | 153 (47.4) | 154 (57.9) |
| Preoperative | 127 (41.3) | 7/153 (4.5) | 120/154 (77.9) |
| Intraoperative | 159 (51.8) | 132/153 (86.3) | 27/154 (17.5) |
| Postoperative | 21 (6.8) | 14/153 (9.2) | 7/154 (4.6) |
| Time to ICP (minutes), median (IQR) | 84 (52–149) | 67 (38–105) | 120 (65–428) |
| Tracheostomy ** | 117 (27.5) | 43(21.3) | 74(33.0) |
| Gastrostomy** | 68(15.9) | 28(13.9) | 40(19.8) |
| POFI, median (IQR) | 0 (0–0) | 0 (0–0) | 0 (0–0) |
| ISS, median (IQR) | 13 (9–22) | 13 (9–22) | 13 (9–19) |
| Single ICISS, median (IQR) | 0.67(0.56–0.77) | 0.62 (0.50–0.77) | 0.68 (0.56–0.77) |
| Multiple ICISS, median (IQR) | 0.11(0.02–0.32) | 0.11 (0.02–0.31) | 0.13 (0.03–0.34) |
DC Decompressive craniectomy, LOS length of stay, IHCA Intrahospital cardiac arrest, OHCA Out of hospital cardiac arrest, DIC Disseminated intravascular coagulation, PCCC Pediatric Complex Chronic Conditions, EVD Extra ventricular drain, ICP Intracranial pressure, POFI Postoperative Organ Failure Index, ISS Injury Severity Score, ICISS International Classification Injury Severity Score, IQR Interquartile range, xx Censored data, NA not available.**Survivors of DC (n = 426).