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[Our experience in the poly-traumatized pediatric patient with criteria for admission to the ICU]
E Calleja Aguayo1, R Delgado Alvira, J Elías Pollina
1Servicio Cirugía Pediátrica, Hospital Universitario Infantil Miguel Servet, Zaragoza. dracalleja@gmail.com
Insights
Severe pediatric trauma is a critical issue, with traffic accidents being a common cause of death in children. Injury Severity Score (ISS) and Glasgow Coma Scale (GCS) effectively predict mortality and complications in pediatric trauma patients.
Area of Science:
- Pediatric Trauma Care
- Intensive Care Medicine
- Injury Epidemiology
Context:
- Pediatric trauma is a leading cause of mortality in children under two years old.
- Severe pediatric trauma necessitates specialized intensive care unit (ICU) management.
- Understanding trauma mechanisms and patient outcomes is crucial for improving care.
Purpose:
- To present the experience of managing severe pediatric trauma cases.
- To analyze the factors associated with mortality and complications in pediatric trauma patients.
- To evaluate the predictive value of Injury Severity Score (ISS) and Glasgow Coma Scale (GCS) in pediatric trauma.
Summary:
- A retrospective study of 78 pediatric patients with multiple trauma admitted to the ICU between 2000 and 2008 was conducted.
- The mean age was 8.5 years, with 70% males. Road traffic accidents were the most common mechanism (45%).
- Mortality was 15%, with 75% occurring within 24 hours. Both ISS and GCS scores were significantly associated with mortality, complications, and ICU length of stay.
Impact:
- The findings highlight the significant impact of severe pediatric trauma on mortality and morbidity.
- Injury Severity Score (ISS) and Glasgow Coma Scale (GCS) are identified as valuable indicators of trauma severity.
- This study provides insights for optimizing management strategies and resource allocation in pediatric intensive care units for trauma patients.
Objective:
To present our experience with severe pediatric trauma. The pediatric trauma is the leading cause of death in children under 2 years.
Methods:
We achieved a retrospective study from 78 pediatric patients admitted to the Intensive Care Unit (UCI) for multiple trauma between 2000 and 2008. Age, sex, season, location, mechanism, Glasgow and ITP, type of injuries, complications, days of hospitalization and deaths were reviewed. It was performed descriptive and analytical study using the SPSS 15.0 and chi square and Pearson correlation were applied.
Outcomes:
The mean age of patients was of 8.5 +/- 4.2 years with 70% boys. Most accidents occurred in summer (37%) and the most common site was the road (47%). There was 15% of mortality, which the 75% occurred in the first 24 hours. There is an association between abdominal trauma and type of mechanism (p < 0.05). The most common mechanism was the traffic accident (45%) followed by a direct hit. Both ITP as Glasgow score were associated significantly with mortality and complications and with the hospital stay in the UCI there was a weak association but significant and negative (p < 0.05).
Conclusions:
Mortality is higher than other series but it may be because that these series include minor injuries. The fall down is the most frequent in pediatric emergencies but it was the mechanism that involves less admission to the UCI. Both ITP as Glasgow score are good indicators of severity and if their values decrease, the hospital stay in UCI and the mortality increase.
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