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Outcomes in Pediatric Trauma Care in the Stockholm Region
Kerstin Sluys1,2,3, Margaretha Lannge4, Lennart Iselius5
1Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden. kerstin.sluys@ki.se.
Insights
Pediatric trauma in Stockholm primarily affects males, with head injuries being most common. Improving trauma registry data quality is crucial for better outcomes.
Area of Science:
- Pediatric Trauma Care
- Injury Epidemiology
- Public Health
Background:
- Trauma is a significant cause of death and disability in children in Sweden.
- Limited research exists on pediatric trauma outcomes in the region.
Purpose of the Study:
- To analyze the demographics, injury patterns, severity, and outcomes of pediatric trauma in Stockholm.
- To identify areas for improvement in trauma care and data collection.
Main Methods:
- Retrospective analysis of all pediatric trauma patients (≤15 years) in Stockholm during 2002.
- Data verification using medical records and autopsy reports.
- Outcome measures included mortality and length of stay in pediatric intensive care unit (PICU) and hospital.
Main Results:
- 432 children were included; median age 10 years, 59% males.
- Head injuries were most common (50%), with a median Injury Severity Score of 4.
- Low mortality (1%), short median hospital stay (2 days), with 19% requiring PICU admission.
Conclusions:
- Head injuries are prevalent across all age groups, particularly severe in young children due to falls.
- Trauma registry data quality is suboptimal, necessitating enhanced completeness and accuracy.
- Refining trauma team activation criteria is recommended to prevent overuse.
Background:
Although trauma is a leading cause of pediatric mortality and morbidity in Sweden, few studies have examined the outcome of pediatric trauma.
Objective:
Here, we describe the age and gender distribution, injury mechanisms, injury severity, and outcome of pediatric trauma in the Stockholm region.
Methods:
This retrospective study comprises all trauma patients (age ≤ 15 years) admitted to a regional pediatric trauma center and all pediatric deaths due to trauma in Stockholm in 2002. Data from the trauma registry database were verified by comparison with medical records and autopsy reports. Outcome was measured by mortality and length of stay in a pediatric intensive care unit (PICU) and acute care hospital.
Results:
In all, 432 injured children were included. The median age was 10 years and 59% were males. The median injury severity score was 4 (interquartile range [IQR] 1-9) and 50% sustained head injuries. Mortality was low (1%) and the median length of hospital stay was 2 days (IQR 1-3); 19% stayed in a PICU and, of those, 89% stayed for one day. Comparison with medical records showed that much information in the trauma registry database was either incorrect or missing.
Conclusions:
Many injuries were minor and half of the children were discharged home from the emergency department.Head injurieswere themost common injury in all age groups. The most severe head injuries were seen in the youngest group and were caused by falls. Trauma team activation criteria should be improved to avoid overutilization. The quality and completeness of data in the trauma registry must be enhanced.
