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Mechanisms, patterns and outcomes of paediatric polytrauma in a UK major trauma centre
G Naqvi1, G Johansson2, G Yip1
1Cambridge University Hospitals NHS Foundation Trust , UK.
Insights
Vehicle incidents are the leading cause of severe paediatric trauma in the UK. Head injuries are most common, and early identification of severe injuries like rib fractures is crucial for better patient outcomes.
Area of Science:
- Trauma Surgery
- Pediatric Emergency Medicine
- Epidemiology
Background:
- Paediatric trauma represents a significant global health challenge, contributing substantially to mortality in the UK.
- Understanding the epidemiology of severe injuries in children is vital for improving healthcare provision.
Purpose of the Study:
- To analyze the epidemiological characteristics of moderate to severe paediatric trauma.
- To identify common injury mechanisms, severity, and outcomes in children.
Main Methods:
- Retrospective analysis of epidemiological data from a UK major trauma centre (January 2012 - December 2014).
- Inclusion criteria: children (≤16 years) with an Abbreviated Injury Scale score of ≥2.
- Data reviewed included demographics, injury mechanism, length of stay, intensive care unit admission, and mortality.
Main Results:
- 213 patients were included, with a mean age of 7.8 years.
- Vehicle-related incidents were the most common cause (46%).
- The mortality rate was 6.6%, with head injury being the most frequent severe injury. Injury Severity Score positively correlated with hospital length of stay (p<0.001).
Conclusions:
- Paediatric trauma exhibits considerable variation in injury mechanisms, severity, and patterns across different age groups.
- A multidisciplinary team approach and management in specialist centres are essential for optimal care and recovery.
- Rib and pelvic fractures serve as critical indicators of injury severity, necessitating a thorough search for associated injuries.
Abstract:
Introduction Paediatric trauma is a significant burden to healthcare worldwide and accounts for a large proportion of deaths in the UK. Methods This retrospective study examined the epidemiological data from a major trauma centre in the UK between January 2012 and December 2014, reviewing all cases of moderate to severe trauma in children. Patients were included if aged ≤16 years and if they had an abbreviated injury scale score of ≥2 in one or more body region. Results A total of 213 patients were included in the study, with a mean age of 7.8 years (standard deviation [SD]: 5.2 years). The most common cause of injury was vehicle related incidents (46%). The median length of hospital stay was 5 days (interquartile range [IQR]: 4-10 days). Approximately half (52%) of the patients had to stay in the intensive care unit, for a median of 1 day (IQR: 0-2 days). The mortality rate was 6.6%. The mean injury severity score was 19 (SD: 10). Pearson's correlation coefficient showed a positive correlation for injury severity score with length of stay in hospital (p<0.001). Conclusions There is significant variation in mechanism of injury, severity and pattern of paediatric trauma across age groups. A multidisciplinary team approach is imperative, and patients should be managed in specialist centres to optimise their care and eventual functional recovery. Head injury remained the most common, with significant mortality in all age groups. Rib fractures and pelvic fractures should be considered a marker for the severity of injury, and should alert doctors to look for other associated injuries.
