{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,17]],"date-time":"2026-01-17T12:03:41Z","timestamp":1768651421531,"version":"3.49.0"},"reference-count":26,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,1,17]],"date-time":"2026-01-17T00:00:00Z","timestamp":1768608000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,1,17]],"date-time":"2026-01-17T00:00:00Z","timestamp":1768608000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Childs Nerv Syst"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective review was conducted of pediatric TBI cases requiring neurosurgery at a tertiary hospital in La Paz, Bolivia (2019\u20132023). 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).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 165 cases were identified with a median age of 4.7\u00a0years (IQR 1.3\u20138.3). Infants had the highest rates of postoperative complications (44%) and reoperations (28%), significantly greater than older children (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01). Infants experienced longer admission-to-surgery delays (median 3 vs. 1\u00a0day,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and nearly double the LOS (median 21 vs. 9\u00a0days,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Children aged 6\u201316\u00a0years more frequently had focal injuries, typically underwent surgery within 1 day, and showed favorable short-term outcomes. Overall, 30\u2011day mortality was 4% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20096), with four deaths within 48\u00a0h postoperatively. While overall 30-day survival (96%) did not differ by age (log-rank\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.45), reoperation-free survival varied significantly (\n                      <jats:italic>\u03c7<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200915.3,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01). Overall, 12% required reoperation by 30\u00a0days, primarily driven by infants (28% vs. 7% in older children;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.02).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Younger 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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00381-026-07134-x","type":"journal-article","created":{"date-parts":[[2026,1,17]],"date-time":"2026-01-17T02:10:20Z","timestamp":1768615820000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Age-stratified neurosurgical outcomes for traumatic brain injury in a pediatric neurosurgical cohort in La Paz, Bolivia"],"prefix":"10.1007","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-1577-2112","authenticated-orcid":false,"given":"Caleigh S.","family":"Roach","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacob J.","family":"Shawwa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Connor","family":"Nee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shreyas","family":"Chetan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George","family":"Dong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony","family":"Rios","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jorge Daniel","family":"Brun","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jorge David","family":"Brun","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Victor M.","family":"Lu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,1,17]]},"reference":[{"issue":"2","key":"7134_CR1","doi-asserted-by":"publisher","first-page":"82","DOI":"10.2176\/nmc.ra.2016-0191","volume":"57","author":"T Araki","year":"2017","unstructured":"Araki T, Yokota H, Morita A (2017) Pediatric traumatic brain injury: characteristic features, diagnosis, and management. 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