Children who Sustain a Head Injury are at Risk for Subsequent Head Injury within 6 Months and 1 Year
Objective: Most children with head injury (HI) are able to return to their previous activities. Some believe that a HI may increase the risk of subsequent HI and the consequences may be serious. There is no strong scientific evidence to support or refute this claim. We designed this study to determine whether children who sought care for a HI were more at risk of having a subsequent HI within 6 and 12 months following the index injury as compared to children who sought care for an injury other than to the head.
Methods: Parents of children to 18 yrs. who visited the emergency department of either one of two Montreal children's' hospitals in 2001-2003 for an injury were interviewed by telephone at 6 (n=10,315) and 12 months (n= 9486) following the index injury. The goal was to identify subsequent injuries and to provide information on other important risk factors such as age, gender, chronic medical condition, child's activity level and parental characteristics and socioeconomic status (SES). Logistic regression was used to estimate the risk of subsequent HI in children with an index HI vs other injuries, while adjusting for potential confounders.
Results: 245 (2.4 %) and 386 (4.1%) children sustained a subsequent HI requiring medical care within the following 6 and 12, respectively. Children who sought care for a HI (exposed, n=3599) were at significantly higher risk (OR 1.7: 95% CI: 1.3 - 2.2) of having a subsequent HI in the following 6 months than children who sought care for a non-HI (n=6716). An adjusted odds ratio of 1.5 (95% CI: 1.2 - 2.0) suggests confounding by age (younger), sex (boys), history of previous HI and maternal education (> high school). Results were consistent at the 12-month follow-up (AOR 1.5: 95% CI: 1.2-1.9).
Conclusion: These results provide evidence that having a HI increases a child's risk of having a subsequent HI. Although the phenomenon is confounded by age, sex, history of previous HI and SES, the risk remains substantial.