ArticleChild's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery2026
Age-stratified neurosurgical outcomes for traumatic brain injury in a pediatric neurosurgical cohort in La Paz, Bolivia.
Article in Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeTo assess age-stratified differences in neurosurgical outcomes following pediatric traumatic brain injury (TBI) in a resource-limited setting, using World Health Organization-defined developmental categories.
methodsA retrospective review was conducted of pediatric TBI cases requiring neurosurgery at a tertiary hospital in La Paz, Bolivia (2019-2023). Primary outcomes included mortality and postoperative complications. Secondary outcomes were admission-to-surgery time, 30-day reoperation/readmission rates, and hospital length of stay (LOS).
resultsA total of 165 cases were identified with a median age of 4.7 years (IQR 1.3-8.3). Infants had the highest rates of postoperative complications (44%) and reoperations (28%), significantly greater than older children (p < 0.01). Infants experienced longer admission-to-surgery delays (median 3 vs. 1 day, p < 0.001) and nearly double the LOS (median 21 vs. 9 days, p < 0.001). Children aged 6-16 years more frequently had focal injuries, typically underwent surgery within 1 day, and showed favorable short-term outcomes. Overall, 30‑day mortality was 4% (n = 6), with four deaths within 48 h postoperatively. While overall 30-day survival (96%) did not differ by age (log-rank p = 0.45), reoperation-free survival varied significantly (χ
conclusionYounger age, particularly infancy, was associated with higher surgical complexity, delays in intervention, and increased complications and reoperations, despite similar survival. Age-specific clinical protocols and early resource prioritization are essential to improve pediatric TBI outcomes in resource-limited environments.
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