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[Comparison of severe multiple injuries in childhood and adulthood]
I Reichmann1, M Aufmkolk, F Neudeck
1Abteilung für Unfallchirurgie, Universitätsklinikum, Essen.
Insights
Children with multiple injuries have a lower mortality rate than adults, with head injuries being the primary cause of death. Surviving children often experience long-term handicaps from lower extremity fractures.
Area of Science:
- Pediatric trauma surgery
- Emergency medicine
- Public health
Background:
- Multiple injuries significantly contribute to childhood mortality and long-term disability.
- Understanding the characteristics of pediatric polytrauma is crucial for effective management and resource allocation.
- Comparing pediatric and adult polytrauma provides insights into age-specific injury patterns and outcomes.
Purpose of the Study:
- To evaluate and compare the characteristics of childhood polytrauma with those of severely injured adults.
- To identify differences in injury mechanisms, injury severity, complications, and outcomes between pediatric and adult polytrauma patients.
Main Methods:
- Retrospective analysis of two groups: 117 children (3-15 years) and 1159 adults (16-59 years) with multiple injuries.
- Groups were matched for overall injury severity.
- Data collected included injury mechanisms, most frequent injury regions, severity of specific injuries, complications, ventilation duration, hospital stay, and mortality.
Main Results:
- Children were more often injured as pedestrians, while adults were more frequently car passengers.
- Extremity fractures were common in both groups, but head injuries represented the greatest severity.
- Adults experienced more complications, including multiple organ failure, isolated liver failure, pneumonia, and lung failure, with longer ventilation and hospital stays.
Conclusions:
- Children with multiple injuries exhibit a lower mortality rate compared to adults.
- Cerebral injuries are the leading cause of death in pediatric polytrauma.
- Fractures of the lower extremities are the most common cause of long-term handicaps in surviving children.
Abstract:
Multiple injuries in children are responsible for a great part of childhood mortality. Remaining handicaps after injuries have a social and economic significance. In this study, the characteristics of polytrauma in childhood are evaluated by comparison with severely injured adults. The two groups of multiple trauma patients (117 children between 3 and 15 years of age and 1159 adults between 16 and 59) were equal in the overall severity of all injuries. Children were mainly hurt as pedestrians, whereas adults had an accident more often as car passengers. The most frequently injured region were in both groups fractures of the extremities. The greatest injury severity represented head injuries in each group. Complications were seen more often in adult patients. Multiple organ failure and isolated liver failure were exclusively seen in the adult group, pneumonia and lung failure occurred significantly more often. The duration of artificial ventilation and the duration of hospital stay were prolonged in the adult group. In summary, children with multiple injuries have a lower mortality rate than adults. The main cause of death are cerebral injuries. Remaining handicaps in surviving children are most often caused by fractures of the lower extremities.