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Global surgery for paediatric casualties in armed conflict
Frederike J C Haverkamp1, Lisanne van Gennip1, Måns Muhrbeck2,3,4
11Department of Surgery, Radboudumc, Geert Grooteplein Zuid, 9101, 618 Nijmegen, the Netherlands.
Insights
Children injured in armed conflicts sustain more frequent fragment, burn, and mine injuries, often affecting multiple body parts. These paediatric casualties also experienced higher in-hospital mortality rates compared to adults.
Area of Science:
- Global Health
- Trauma Surgery
- Pediatric Medicine
Background:
- Understanding specific injury patterns in pediatric conflict casualties is crucial for medical preparedness.
- Organizations providing medical care in conflict zones require data on pediatric trauma.
Purpose of the Study:
- To identify injury patterns and treatment needs specific to pediatric patients in conflict zones.
- To analyze characteristics of children treated in International Committee of the Red Cross (ICRC)-supported facilities.
Main Methods:
- Retrospective cohort study analyzing data from 1988-2014.
- Included pediatric patients (age < 15 years) treated in six global facilities.
- Compared pediatric patient characteristics with adult patients (age >= 15 years).
Main Results:
- Pediatric patients constituted 15% of all treated individuals (5843/38,088).
- Children had higher rates of fragment, burn, and mine injuries compared to adults.
- Pediatric patients sustained injuries to multiple body regions more often and had higher in-hospital mortality.
Conclusions:
- Children in armed conflicts face distinct injury profiles and higher mortality risks.
- Findings inform ICRC and other organizations on necessary personnel and logistical preparations for pediatric trauma victims.
Background:
Understanding injury patterns specific for paediatric casualties of armed conflict is essential to facilitate preparations by organizations that provide medical care in conflict areas. The aim of this retrospective cohort study is to identify injury patterns and treatment requirements that are specific for paediatric patients in conflict zones.
Methods:
Characteristics of children (age < 15 years) treated in medical facilities supported by the International Committee of the Red Cross (ICRC) between 1988 and 2014 in Kabul, Kao-i-Dang, Lokichogio, Kandahar, Peshawar, Quetta and Goma were analysed; patient characteristics were compared between treatment facilities and with those of adult patients (age ≥ 15 years).
Results:
Of the patients listed in the database, 15% (5843/38,088) were aged < 15 years. The median age was 10 years (IQR 6-12); 75% (4406/5843) were male. Eighty-six percent (5012/5,843) of the admitted children underwent surgery, with a median of 2 surgeries per patient (IQR 1-3). When compared with adult patients, children were more frequently seen with fragment injuries, burns and mine injuries; they had injuries to multiple body regions more often and had higher in-hospital mortality rates.
Conclusions:
Children more often sustained injuries to multiple body regions and had higher in-hospital mortality than adults. These findings could have implications for how the ICRC and other organizations prepare personnel and structure logistics to meet the treatment needs of paediatric victims of armed conflicts.
