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Severe and fatal childhood trauma
P Suominen1, A Kivioja, J Ohman
1University of Helsinki, Finland.
Insights
Severe childhood trauma, primarily blunt injuries and road traffic accidents, affects 14.1 per 100,000 children annually. Most deaths from severe pediatric trauma occur within hours of the incident.
Area of Science:
- Pediatric Trauma Epidemiology
- Injury Prevention in Children
- Public Health and Traumatology
Background:
- Severe childhood trauma poses a significant public health challenge.
- Understanding the epidemiology and outcomes of severe pediatric injuries is crucial for effective intervention.
- Previous studies have highlighted the impact of trauma on child mortality and morbidity.
Purpose of the Study:
- To investigate the epidemiology and outcomes of severe childhood trauma in southern Finland.
- To identify the primary causes and injury patterns in severely injured children.
- To determine the incidence and mortality rates associated with severe pediatric trauma.
Main Methods:
- A retrospective study was conducted over a 10-year period.
- Data were collected from 347 severely injured children under 16 requiring intensive care or who died.
- Injury types, causes, and survival outcomes were analyzed.
Main Results:
- Blunt injuries (83.0%) and road traffic accidents (58.2% of injuries, 59.3% of deaths) were the leading causes.
- Head injuries were prevalent, often combined with other injuries (85.6% of blunt/penetrating trauma).
- Annual incidence was 14.1/100,000 children, with mortality at 4.8/100,000; most deaths occurred within 6 hours.
Conclusions:
- Road traffic accidents are the predominant cause of severe pediatric trauma and mortality.
- Severe childhood trauma predominantly involves blunt mechanisms and head injuries.
- Timely intervention is critical as most trauma deaths occur rapidly, without late complications like sepsis.
Abstract:
We wanted to study epidemiology and the outcome of severe childhood trauma. A retrospective study was carried out of 347 severely injured children under 16 years of age, who required intensive care or died during a 10-year period in southern Finland. Of the severely injured children, 65.4 per cent were male. Blunt injuries were the most common (83.0 per cent) followed by penetrating injuries (4.9 per cent), burns (4.6 per cent) and others (7.5 per cent). Of the patients with blunt or penetrating trauma, 85.6 per cent had head injury alone, or combined with other injuries. The majority of all injuries (58.2 per cent) and deaths (59.3 per cent) in children were caused by road traffic accidents. Of this patient population, 64 died at the scene, 54 died in hospital and 229 survived. Most of the deceased trauma patients (77.1 per cent) died within the first 6 h following the incident and all the deaths occurred within 9 days. The annual incidence of severe trauma was 14.1 per 100,000 children, and the annual mortality was 4.8 per 100,000. All the trauma deaths occurred immediately or within a few days of the accident. Late trauma deaths due to sepsis or multiple organ failure were not seen in children.