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Paediatric Trauma Presentations in a Teaching Hospital in Lagos, Nigeria: Epidemiology and Predictor of Mortality
O I Akinmokun1, M O Afolayan2, T O Odugbemi3
1Department of Surgery, College of Medicine, University of Lagos, Idi-Araba, and Department of Orthopaedic and Traumatology, Lagos University Teaching Hospital, Idi-Araba, Lagos State, Nigeria.
Insights
Paediatric trauma is a significant health issue, with falls at home being the most common cause of injury in children. Road traffic accidents, however, led to the most fatalities, highlighting the need for continued vigilance and intervention strategies.
Area of Science:
- Public Health
- Epidemiology
- Trauma Surgery
Background:
- Paediatric trauma presents a substantial global health challenge, leading to significant hospitalizations and adverse outcomes in children and adolescents.
- Understanding the specific epidemiology and patterns of paediatric injuries is crucial for developing targeted prevention and management strategies.
Purpose of the Study:
- To investigate the epidemiology, injury patterns, and outcomes of paediatric trauma cases.
- To identify the primary causes and circumstances surrounding paediatric injuries in a specific Nigerian teaching hospital.
Main Methods:
- A prospective observational hospital-based study was conducted over 13 months.
- Included all paediatric trauma patients under 18 years presenting to the accident and emergency room.
- Data were analyzed using Stata v13.
Main Results:
- 154 patients experienced 250 injuries; the mean age was 6.8 years (males 1.5:1 ratio).
- Most injuries (51.3%) occurred at home, with falls being the most frequent cause (46.8%). Traumatic brain injury was the most common diagnosis.
- The crude mortality rate was 5.8%, with road traffic accidents contributing to the majority of deaths. The paediatric trauma score accurately predicted mortality.
Conclusions:
- Paediatric trauma remains a critical public health concern, particularly affecting school-aged children.
- Home-based falls are the leading cause of paediatric trauma, while road traffic injuries are associated with higher mortality.
- The paediatric trauma score is a reliable predictor of mortality and should be integrated into routine clinical practice.
Introduction:
Paediatric trauma remains a major health challenge worldwide. It remains a major reason for hospitalization among children and adolescents around the world, with resultant death or disability. This study was aimed to determine the epidemiology, pattern and outcomes of paediatric injuries presenting at a teaching hospital in Lagos, South-west Nigeria.
Patients And Methods:
This was a prospective observational hospital based study conducted on all paediatric trauma patients below 18 years, who presented at the accident and emergency room of the Lagos University Teaching Hospital (LUTH) over a period of thirteen months. Data analysis was done with Stata v13 (StataCorp. Texas. USA).
Results:
A total of 154 patients sustained 250 documented injuries. The mean age was 6.8 ± 4.6 years. Male to female ratio was 1.5:1. Children aged 8 years were mostly affected. There was significant statistical association between age of child at injury and the place of injury. (p = 0.021) Most injuries (51.3%) occurred at home followed by the road. Falls accounted for 72 cases (46.8%). Traumatic brain injury was the most common injury sustained. Injuries at home peaked at 5pm and extended to 7pm while injuries from road traffic accidents peaked at two periods; between 7am and 8am and 4pm. Paediatric trauma score predicted death accurately. The crude mortality rate was 5.8%.
Conclusion:
Paediatric trauma scourge is still a health concern. School age children are mostly affected by trauma. Falls were the most common cause of trauma in children and most falls occurred in the home environment. Injuries from road traffic accidents accounted for majority of deaths. The paediatric trauma score predicts mortality in injured children and should be routinely used.
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