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Major trauma with multiple injuries in German children: a retrospective review
Christian Buschmann1, Christian A Kühne, Christian Lösch
1Department of Orthopedic Surgery, University of Aachen, Aachen, Germany. christian.buschmann@gmx.de
Insights
Multiple-injured children have different injury patterns than adults, with head injuries being most common. The youngest children (0-5 years) faced the highest mortality rates in this German trauma registry study.
Area of Science:
- Traumatology
- Pediatric Emergency Medicine
- Public Health
Background:
- The German trauma registry study (Traumaregister) of the German Society of Trauma Surgery collected data from 1997-2003.
- This study focuses on multiple-injured children and compares their outcomes to adults.
Purpose of the Study:
- To evaluate demographics, injury mechanisms, patterns, severity, and outcomes in multiple-injured children.
- To compare pediatric trauma patients with adult trauma patients.
Main Methods:
- Analysis of 517 children (0-15 years) with an Injury Severity Score >15 from 103 German trauma centers.
- Comparison with 11,025 adult trauma patients.
- Assessment of injury mechanisms, patterns, severity (Injury Severity Score, Revised Trauma Score), and mortality.
Main Results:
- Traffic accidents were the primary cause of injury.
- Head injuries were most prevalent in children; severe thoracic injuries increased with age.
- Children had shorter intensive care unit (ICU) and mechanical ventilation durations than adults.
Conclusions:
- Significant differences exist in injury mechanisms and patterns between pediatric and adult trauma patients.
- Youngest children (0-5 years) exhibited the highest in-hospital mortality rates.
- Adults required longer mechanical ventilation and ICU treatment compared to children.
Background:
The aim of this study was to evaluate the demographics, mechanisms, pattern, injury severity, and the outcome (ie, length of intensive care unit [ICU] stay, length of mechanical ventilation, total length of stay, mortality) in multiple-injured children based on a review from the German trauma registry study ("Traumaregister") of the German Society of Trauma Surgery (Deutsche Gesellschaft für Unfallchirurgie e.V.).
Methods:
One hundred three German trauma centers took part in the German trauma registry study from January 1997 to December 2003. Five hundred seventeen children (aged 0-15 years) with multiple injuries and an Injury Severity Score of more than 15 in comparison to 11,025 adults were included. Sex, age, and mechanisms and pattern of injury were assessed. The mechanisms of trauma and the anatomical distribution of severe injury (Abbreviated Injury Scale of 3 or more) were analyzed. The Injury Severity Score, the Revised Trauma Score, and the Trauma Score Injury Severity Score were calculated to estimate the severity of injury and mortality.
Results:
The predominant sex was male. Most cases were caused by traffic-related accidents. Head injuries were most common in children, and severe thoracic injuries increased with age. Mean length of ICU treatment, mechanical ventilation, and total length of stay were shorter in children than in adults. A total of 22.6% of the children aged 0 to 5 years died in the hospital in comparison with in-hospital mortality rate of 13.7% in the 6- to 10-, 20.3% in the 11- to 15-, and 17.0% in the 16- to 55-year-old patients.
Conclusions:
There were differences between multiple-injured children and adults concerning injury mechanisms and pattern of injuries. Adults needed a longer mechanical ventilation and a longer ICU therapy. Most deaths could be seen in the youngest patients aged 0 to 5 years.
