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[Multiple trauma in children younger than 16 years; a retrospective study over the 1984-1991 period]
R W Koot1, C van der Werken, A A op de Coul
1St. Elisabeth Ziekenhuis, afd. Intensive Care, Tilburg.
Insights
Pediatric trauma patients generally have good outcomes, with lower rates of severe complications like Respiratory Distress Syndrome and Multi-Organ Failure. External fixation is an effective treatment for fractures in children.
Area of Science:
- Trauma surgery
- Pediatric critical care
- Injury epidemiology
Context:
- Multiple injuries in children present unique challenges in evaluation, treatment, and outcome prediction.
- Understanding pediatric trauma patterns is crucial for developing targeted interventions.
- Comparing pediatric and adult trauma outcomes informs clinical practice and resource allocation.
Purpose:
- To evaluate the incidence, treatment strategies, and outcomes of multiple injuries in pediatric patients.
- To compare pediatric trauma characteristics and outcomes with those of adult trauma patients.
- To assess the effectiveness of external fixation as a treatment modality for pediatric fractures.
Summary:
- Children with severe injuries are often involved in motor vehicle accidents, with rib fractures being uncommon.
- Pediatric trauma patients experienced shorter Intensive Care Unit stays and did not develop Respiratory Distress Syndrome or Multi-Organ Failure.
- External fixation is a preferred treatment for fractures in children, and the Paediatric Trauma Score offers no advantage over the Injury Severity Score for these patients.
Impact:
- Pediatric trauma outcomes are generally favorable, partly due to a lower incidence of severe complications and a higher prevalence of diffuse brain injuries.
- External fixation is a highly effective treatment for pediatric fractures.
- The study highlights the distinct patterns and outcomes of severe injuries in children compared to adults, guiding future research and clinical management.
Objective:
Evaluation of incidence, treatment and outcome of multiple injuries in children and adults.
Method:
All patients aged 16 years or under with an Injury Severity Score of 18 or more admitted to the Intensive Care Unit between 1984 and 1991, were retrospectively studied. Type and severity of injuries, treatment, complications and outcome were noted. The severity of injuries was scored using both the Injury Severity Score and the Paediatric Trauma Score.
Results:
Children are more likely to be run over by motor vehicles. Rib fractures are rare in childhood. Compared with adults, children stay relatively shortly in the Intensive Care Unit. None of the children studied developed a Respiratory Distress Syndrome (RDS) or Multi-Organ Failure (MOF). External fixation of fractures is a common treatment in children.
Conclusions:
I. Outcome of multiple injuries in children is relatively good. This can partly be attributed to the low incidence of RDS and MOF, but also to the more common diffuse brain injury in children compared with adults, with better outcome and lower mortality. 2. External fixation of fractures appears to be a first rate treatment in children. 3. Scoring of multiple injuries in children with the Paediatric Trauma Score instead of the Injury Severity Score offers no advantages.