The scope of early traumatic brain injury as a long-term health concern in two nationwide samples: Prevalence and prognostic factors

Primary objectives: To examine the scope of paediatric traumatic brain injury (TBI) as a health concern and to identify prognostic factors for TBI-related sequelae. Methods and procedures: The study was prospective and nationwide. A questionnaire was sent to a study group (SG) of all 0-19 years old in Iceland, diagnosed similar to 16 years earlier with TBI during a 1-year period, 1992-1993 (n = 550) and to a control group (CG) (n = 1232), selected from the National Register. Main outcomes and results: In the CG 49.5% reported having sustained TBI and 7.0% reported long-term disability. In the group with TBI, force of impact to the head, more than one incident of TBI and the injury severity by gender interaction predicted late symptoms. TBI severity had substantially less effect than force of impact and was close to non-existent for females. Conclusions: Based on two independent nationwide samples, the scope of TBI as a health concern in adolescence and young adulthood is greater than previously documented. The findings suggest that TBI event-related factors, especially force of impact, have greater predictive value than clinical symptoms of severity at the acute stage, females being more sensitive to the effects of mild TBI than males.