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Epidemiological analysis of a 10-year retrospective study of pediatric trauma in intensive care
1Department of Surgical Intensive Care Unit, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, 3333 Binsheng Road, Hangzhou, 310052, Zhejiang, People's Republic of China.
Insights
Traffic accidents and falls are leading causes of pediatric trauma, particularly in young children and rural areas. Prevention strategies should focus on child restraints, protective gear, and targeted interventions for high-risk groups.
Area of Science:
- Pediatric Trauma
- Injury Prevention
- Public Health
Background:
- Pediatric trauma significantly contributes to child mortality.
- Traffic injuries and falls are primary causes of severe injuries in children.
- Geographical factors are crucial for developing effective injury prevention strategies.
Purpose of the Study:
- To analyze trends, demographics, injury patterns, and risk factors in pediatric trauma patients admitted to the ICU.
- To identify key causes and circumstances of pediatric trauma.
- To inform the development of targeted prevention strategies.
Main Methods:
- Retrospective analysis of clinical data from 951 pediatric trauma ICU patients over 10 years.
- Inclusion of demographics, injury types, treatment details, and outcomes.
- Analysis of geographical factors, time of incidents, and injury locations.
Main Results:
- Traffic accidents (47.9%) and falls (42.5%) were the leading causes of injury.
- Most injured children were aged 0-6 years (70.7%) and male (60.0%).
- Injuries frequently occurred on roadsides (49%) and in rural areas (64.35%), often between 12 PM and 6 PM on non-workdays.
Conclusions:
- Traffic injuries remain the leading cause of pediatric trauma requiring ICU admission.
- Emphasis on child restraint systems and protective gear is crucial for prevention.
- Targeted interventions are needed for high-risk populations, including young children and rural residents.
Abstract:
Pediatric trauma plays a crucial role in pediatric mortality, with traffic injuries and falls frequently cited as leading causes of significant injuries among children. A comprehensive investigation, including geographical factors, is essential for developing effective strategies to prevent injuries and alleviate the burden of pediatric trauma. This study involved a retrospective analysis of clinical data from pediatric patients admitted to our hospital's intensive care unit (ICU) due to trauma over a 10-year period. Comprehensive analyses were conducted to elucidate trends, demographics, injury patterns, and risk factors associated with these admissions. This retrospective study included 951 pediatric patients (mean age: 4.79 ± 3.24 years; mean weight: 18.45 ± 9.02 kg; median time to ICU admission post-injury: 10.86 ± 14.95 h). Among these patients, 422 (44.4%) underwent emergency surgery, and 466 (49%) required mechanical ventilation support, with a mean duration of 70.19 ± 146.62 h. The mean duration of ICU stay was 6.24 ± 8.01 days, and the overall mean hospitalization duration was 16.08 ± 15.56 days. The predominant cause of unintentional injury was traffic accidents (47.9%), followed by falls (42.5%) and burns/scalds (5.3%). Most incidents involved children aged 0-6 years (70.7%), with males comprising 60.0% of patients. Injury incidents predominantly occurred between 12 and 6 PM (44.5%) and on non-workdays (37.6%). The most common locations where injuries occurred were roadsides (49%) and rural areas (64.35%). Single-site injuries (58.78%) were more prevalent than multiple-site injuries (41.22%), and head injuries were the most common among single-site injuries (81.57%). At ICU admission, the mean injury severity score was 18.49 ± 8.86. Following active intervention, 871 patients (91.59%) showed improvement, while 80 (8.41%) succumbed to their injuries. Traffic injuries remain the primary cause of pediatric trauma leading to ICU admission, underscoring the importance of using appropriate child restraint systems and protective gear as fundamental preventive measures. The increased incidence of injuries among children aged < 6 years and those residing in rural areas highlights the need for targeted preventive strategies, necessitating tailored interventions and public policy formulations that address these high-risk populations.
