Related Experiment Videos
The effect of patient age upon survival in pediatric trauma
D K Nakayama1, W S Copes, W J Sacco
1Benedum Pediatric Trauma Program, Children's Hospital of Pittsburgh, PA 15213.
Insights
Childhood injury survival rates are similar across age groups (0-14 years) when injury severity is accounted for. This study found no significant age-related differences in survival after trauma in children.
Area of Science:
- Pediatric Trauma Research
- Injury Epidemiology
- Childhood Development and Health
Background:
- Developmental changes in children may influence survival after severe injury.
- The impact of age on pediatric trauma survival remains unclear.
- Existing data on age-related survival differences in pediatric trauma is limited.
Purpose of the Study:
- To investigate the effect of age on survival rates in pediatric trauma patients.
- To analyze age-specific differences in injury severity and outcomes.
- To determine if age influences survival independently of injury severity.
Main Methods:
- Analysis of trauma registry data for 4,615 patients under 15 years old.
- Stratification of patients into age groups: 0-4, 5-9, and 10-14 years.
- Utilized Abbreviated Injury Scale (AIS), Injury Severity Score (ISS), Revised Trauma Score (RTS), and TRISS methodology for survival prediction.
Main Results:
- No significant differences in survival rates for head, thoracic, or abdominal injuries across age groups.
- Survival rates were lowest in the 0-4 year group for Injury Severity Score cohorts, but not significantly.
- TRISS analysis indicated a higher number of unexpected survivors in pediatric trauma compared to benchmarks, irrespective of age group.
Conclusions:
- Childhood injury survival appears independent of the age groups studied (0-14 years) when injury severity is controlled.
- Age does not significantly impact survival probability after pediatric trauma in this dataset.
- Further research may be needed to explore subtle age-related factors in pediatric trauma outcomes.
Abstract:
Developmental changes in the anatomy and physiology of growing children are thought to improve the survivability of older children to significant injury. The effect of age upon survival, however, is poorly defined. Data for 4,615 patients less than 15 years old from a statewide trauma center registry were analyzed. Injury and survival were characterized by Abbreviated Injury Scale (AIS, 1985 revision), Injury Severity Score (ISS), Revised Trauma Score (RTS), and probability of survival [P(s)] and Z by TRISS. Patients were separated into age groups of 0 through 4, 5 through 9, and 10 through 14 years. The survival rate for patients with a maximum AIS 3 for any region was significantly higher in the 10-14-year age group. There were no significant differences in survival rates from head, thoracic, and abdominal injuries stratified by AIS among the three age groups. Survival rates for ISS cohorts were consistently lowest in the 0-4-year age group, but differences failed to reach significance. Survival for RTS and P(s) intervals were similar for all ages. The Z statistic reached significance for all children (Z = 4.717, W = 1.049), and for each group (Z = 2.203-3.029). Corresponding values of the W statistic suggest approximately one additional unexpected survivor per 100 admitted children when compared with the Major Trauma Outcome Study. Logistic regression for patients with all data required for TRISS showed no significant effect for any of the three age groups. We conclude that for this patient set, survival after childhood injury is independent of the age groups used in this study, after controlling for injury severity.