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Paediatric trauma in Spain: a report from the HUGM Trauma Registry
J A Navascués1, J Matute, J Soleto
1Division of Paediatric Surgery, Hospital Infantil "Gregorio Marañon", Madrid, Spain. juannavascues@terra.es
Insights
This study analyzed pediatric trauma cases, finding falls and street accidents most common. Effective management and prevention programs are crucial for reducing pediatric trauma morbidity and mortality.
Area of Science:
- Pediatric Trauma Care
- Injury Epidemiology
- Public Health
Background:
- Paediatric trauma represents a significant public health concern.
- Understanding injury mechanisms and patient characteristics is vital for effective management.
Purpose of the Study:
- To analyze the characteristics of pediatric trauma patients.
- To evaluate etiological mechanisms and injury patterns.
- To assess pre- and intra-hospital management, morbidity, and mortality.
Main Methods:
- A retrospective analysis of 2633 children admitted to a trauma center between 1995 and 2002.
- Inclusion of 108 variables, including accident details, care received, injury severity scores (Paediatric Trauma Score and Injury Severity Score), lesions, treatments, and outcomes.
Main Results:
- Accidents were more common in boys (68.5%), with the 12-15 age group most affected (36.8%).
- Street accidents (37.2%) and falls (35.6%) were the predominant scenarios.
- Locomotor system injuries (58.1%) and head injuries (34.9%) were most frequent. Mortality was 0.5%, rising to 12.8% for severe trauma patients (ISS > 15).
Conclusions:
- Data analysis aids in defining pediatric trauma population characteristics.
- Monitoring trauma management across care levels and developing prevention programs are essential.
- Comparing results with other centers helps identify and correct deficiencies in the care system.
Objectives:
To analyse the characteristics of the infant population suffering trauma in our setting. To evaluate the importance of the different aetiological mechanisms. To study the pre- and intra-hospital management of these children. To describe the relative significance of the different lesions. To establish the magnitude of paediatric trauma as a social problem in terms of morbidity and mortality.
Material And Methods:
From January 1995 to April 2002, a total of 2633 children admitted to our Centre (Hospital Universitario Gregorio Maranon) after suffering some type of injury were included in our Trauma Register. 108 variables have been analysed, including the identification of the patient, type, site and mechanism of the accident, pre-hospital care, transport, complete evaluation on admission, indices of injury severity, diagnostic tests, lesions, treatments performed and morbidity and mortality.
Results:
The accidents were more frequent in boys than in girls (68.5 % versus 31.5 %). The predominant age group was the 12 - 15 year old group (36.8 %). There was a higher frequency of accidents in the street (37.2 %) than at home (19.4 %) or at school (13.8 %). The most frequent mechanism was a fall (35.6 %), followed by road traffic accidents (23.7 %). On admission, 14.7 % of the children had a Paediatric Trauma Score (P.T.S.) < or = 8 (n = 388). 3.8 % were considered severe multiple trauma patients, presenting an Injury Severity Score (I.S.S.) > or = 15 (n = 101). 4.2 % of the children required intensive care. The most frequent lesions were those of the locomotor system (58.1 %) and head injuries (34.9 %). Some type of surgical or orthopaedic procedure was performed under general anaesthesia in 1522 patients (57.8 %). The mean length of stay was 4.4 days (range 1 - 214 days). Sequelae of some form were detected in 36.4 % of the patients over 3 years of age. The total mortality was 0.5 % (n = 13), being 12.8 % in the group of patients with an I.S.S. > or = 15.
Conclusions:
Analysis of the data in our Registry has helped us to define the characteristics of the paediatric trauma population in our setting, to monitor the management of trauma in the different care levels and to develop prevention programmes. It has also enabled us to compare the results with those of other centres in terms of morbidity and mortality with the aim of identifying and correcting any possible deficiencies in the care system.
