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Preventable pediatric trauma deaths in a metropolitan region
E H Dykes1, L J Spence, J G Young
1Department of Surgery, Hospital for Sick Children, Toronto, Ontario, Canada.
Journal of Pediatric Surgery
|January 1, 1989
Summary
Pediatric trauma deaths in Toronto revealed that 13% of child fatalities were preventable. Objective criteria identified survivable injuries, suggesting a lower preventable death rate than in adults.
Area of Science:
- Traumatology
- Pediatric Emergency Medicine
- Public Health
Background:
- Pediatric trauma remains a significant cause of mortality in children.
- Accurate assessment of injury severity is crucial for determining preventability.
- Previous studies on preventable death rates (PDR) in pediatric trauma are limited.
Purpose of the Study:
- To analyze pediatric trauma deaths in metropolitan Toronto using objective injury severity criteria.
- To estimate the preventable death rate (PDR) in pediatric trauma cases.
- To compare the PDR in pediatric trauma with that of adult trauma victims.
Main Methods:
- Retrospective analysis of all pediatric trauma deaths in Toronto in 1986 using coroner's records.
- Injury scoring using the Abbreviated Injury Scale (AIS) and Injury Severity Score (ISS).
- Definition of 'unsalvageable' injuries based on AIS 6, AIS 5 head/neck, or ISS > 59.
Main Results:
- Out of 38 pediatric trauma deaths, 8 (21%) had injuries deemed survivable using objective criteria.
- Considering social circumstances where medical aid was not sought, the estimated preventable death rate (PDR) was 5/38 (13%).
- The identified PDR in pediatric trauma may be lower than previously reported for adult trauma victims.
Conclusions:
- Objective criteria can effectively identify survivable injuries in pediatric trauma.
- A realistic estimate of preventable death rate in pediatric trauma is approximately 13%.
- Defining PDR with objective criteria facilitates comparative studies and enhances understanding of pediatric trauma outcomes.