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[Events related with injury severity in pediatric multiple trauma]
E de Tomás1, J A Navascués, J Soleto
1Servicio de Cirugía Pediátrica, HGU Gregorio Marañón , Madrid.
Insights
Traffic-related injuries are the primary cause of severe multiple trauma in children, leading to significant mortality and disability. Implementing educational programs and promoting the use of restraining devices are crucial for prevention.
Area of Science:
- Pediatric Traumatology
- Epidemiology
- Public Health
Context:
- Multiple trauma in children presents a significant public health challenge.
- Understanding the etiological factors is crucial for effective prevention strategies.
- This study analyzes trauma cases in a specific geographical region.
Purpose:
- To conduct an epidemiological analysis of the primary factors contributing to multiple trauma in children.
- To identify key risk factors and characteristics of severely injured pediatric trauma patients.
Summary:
- A review of 79 severely injured pediatric trauma patients (Injury Severity Score > 15) revealed traffic-related incidents as the leading cause (77.2%).
- The average Injury Severity Score was 23.4, with most patients suffering multiple injuries (87.3%), predominantly cranial trauma.
- High rates of intensive care unit admission (65.8%) and mortality (11.4%) were observed, with functional or anatomical disability in 94.3% of survivors.
Impact:
- Findings underscore the critical need for enhanced road safety education and mandatory use of child restraint systems.
- The study highlights the severe consequences of pediatric trauma, emphasizing the importance of preventative measures.
- Data can inform public health policies aimed at reducing childhood trauma incidence and severity.
Aims:
Epidemiological analysis of main factors affecting multiple trauma in children in our environment.
Methods:
We reviewed the data collected from the patients (n = 2.166) admitted to our hospital because of trauma and included in our Registry from January 1995 to December 2000. Among this group 79 patients were considered severely injured trauma patients according Injury Severity Score (ISS) (ISS > 15) and selected for the study. Statistical analysis was done using chi2 and Student t test, p values under 0.01 were considered significant.
Results:
Group gender distribution was 49 males and 30 females, age average was 9.7 years (range 0-15 years) Traffic related injuries were the leading cause of trauma in this group (77,2%). Initial triage by using the Pediatric Trauma Score allowed identifying the injury severity in 73,4% of patients (58 children obtained a PTS < or = 8). In 32,9% of the cases the patient was in coma at admission in the Emergency (Glasgow Coma Scale < or = 8, n = 26). ISS average was 23.4 (range 16-75). Most patients suffered from multiple injuries (87,3%), average of injuries number was 4,7 (range 1-9). The most frequent trauma localization was cranial trauma. Admission in the intensive care unit was necessary in 65,8% of patients, and any kind of surgical procedure was done in 35,4%. Average length of stay was 17,1 days (range 0-214 days). Injury severity was higher in automotive patients without restraining systems (I.S.S. average 27,2, mortality 16,6%). Overall mortality was 11,4% (n = 9), and 94.3% of patients presented any functional or anatomic disability.
Conclusions:
Traffic related injuries are the main cause of multiple trauma in children. The severity and high mortality of these injuries make imperative polytonal education systems and the use of restraining devices.
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