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Strangulation injuries in children. Part 1. Clinical analysis
R A Sabo1, W C Hanigan, K Flessner
1Department of Neurosurgery, University of Illinois College of Medicine at Peoria 61656, USA.
The Journal of Trauma
|January 1, 1996
Summary
Strangulation injuries in children are a significant concern, with accidental causes in younger children and intentional acts in older ones. Early resuscitation and injury severity are key to survival and recovery.
Area of Science:
- Pediatric critical care
- Trauma surgery
- Childhood injury prevention
Background:
- Strangulation is a serious cause of death and injury in children.
- A significant percentage of strangulation deaths in Peoria County involved minors.
- Childhood strangulation injuries present with diverse etiologies and outcomes.
Purpose of the Study:
- To analyze the clinical characteristics, causes, and outcomes of strangulation injuries in children.
- To identify factors influencing prognosis and potential complications.
- To inform preventative strategies for childhood strangulation.
Main Methods:
- Retrospective clinical review of 13 pediatric patients treated for strangulation from 1985-1994.
- Analysis of injury causes, initial severity (Glasgow Coma Scale), diagnostic imaging (cervical roentgenograms, CT scans), interventions, and patient outcomes.
- Comparison with previous literature on pediatric strangulation.
Main Results:
- Strangulation accounted for 7.4% of child deaths in the study period.
- The incidence was 32 per 10,000 intensive care unit admissions, with a male predominance (5.5:1).
- Accidental strangulation occurred in younger children, while suicide/autoerotic acts were seen in older ones; 5 children had pre-existing behavioral disorders. Pulmonary complications were frequent, but elevated intracranial pressure indicated a poor prognosis.
Conclusions:
- The severity of initial injury and effectiveness of resuscitation significantly determine outcomes in pediatric strangulation.
- Pulmonary complications are common, and elevated intracranial pressure is a poor prognostic indicator, suggesting monitoring.
- Preventative measures targeting accidental strangulation in infants and intentional strangulation in children with behavioral disorders are crucial.