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Pediatric trauma in an austere combat environment

Philip C Spinella1, Mathew A Borgman, Kenneth S Azarow

  • 1Department of Pediatrics (PCS), Connecticut Children's Medical Center, Hartford, CT, USA. pspinella@ccmckids.org

Critical Care Medicine
|July 18, 2008
PubMed

Insights

Pediatric patients admitted to U.S. military hospitals for traumatic injuries represent a significant patient group with higher mortality rates than adults. Younger children (<6 years) faced the greatest risk, highlighting critical care disparities.

Area of Science:

  • Military Medicine
  • Pediatric Traumatology
  • Epidemiology

Background:

  • U.S. combat support hospitals in Iraq and Afghanistan treated pediatric patients (<18 years) with traumatic injuries.
  • Understanding the epidemiology and care challenges for this demographic is crucial for optimizing medical support in deployed settings.

Purpose of the Study:

  • To describe the epidemiology of pediatric patients admitted with traumatic injuries to U.S. combat support hospitals.
  • To identify critical and noncritical care challenges faced by these pediatric patients.

Main Methods:

  • A descriptive report was conducted.
  • Data were collected from seven combat support hospitals in Iraq and Afghanistan.
  • The study included all pediatric patients under 18 years of age admitted with traumatic injuries.

Main Results:

  • Pediatric patients constituted 7.1% of admissions, utilizing 12% of hospital bed days, with longer lengths of stay than adults.
  • Children represented 13% of deaths and 11% of mechanical ventilation cases.
  • In-hospital mortality for pediatric patients (5.4%) was significantly higher than for adult coalition (1.3%) and noncoalition (4.3%) patients (p < .05).
  • Mortality was markedly higher in children under 6 years (10.7%) compared to older children (3.8%) (p < .05).

Conclusions:

  • Pediatric patients with traumatic injuries are a common and vulnerable population in deployed U.S. military facilities.
  • These children experience higher in-hospital mortality rates compared to adults, with younger children facing the most significant risk.
  • While care has improved, further enhancements and coalition support are needed for pediatric trauma care in military settings.
Abstract

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