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Griffin BR, Trenoweth K, Dimanopoulos TA, De Young AC, Cobham VE, Williams H, Kimble R. Co-design of a paediatric post-trauma electronic psychosocial screen. J Pediatr Nurs 2024; 76:52-60. [PMID: 38359545 DOI: 10.1016/j.pedn.2024.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 02/06/2024] [Accepted: 02/06/2024] [Indexed: 02/17/2024]
Abstract
PURPOSE To optimise care pathways and provide greater transparency of the psychosocial needs of injured children after hospital discharge by extending post-discharge psychosocial screening to children admitted with traumatic injury for ≥24 h. DESIGN AND METHODS This mixed-methods study used a co-design approach informed by the Experience-Based Co-design (EBCD) framework. Interviews with carers were used to evaluate experiences and generate views on psychosocial support interventions. Online surveys by international child psychologists' indicated preferences for a psychosocial screening tool, and clinician-stakeholder consensus meetings facilitated the development of an electronic post-injury psychosocial screening tool. RESULTS Carers found the initial year of follow-up from trauma family support services helpful, appreciating the hospital connection. Flexible follow-up timings and additional resources were mentioned, and most carers were interested in participating in an electronic screening activity to predict their child's coping after injury. Child trauma experts recommended including several screening tools, and the multidisciplinary paediatric trauma service and study investigators collaborated over a year to workshop and reach a consensus on the screening tool and follow-up process. CONCLUSION The multidisciplinary team co-designed an electronic psychosocial screening and follow-up process for families with children with traumatic injuries. This tool improves the visibility of injured children's psychosocial needs post-injury and potentially aids clinical targeted resource allocation for trauma family support services. PRACTICE IMPLICATIONS The study emphasises the significance of specialised psychosocial screening tools in paediatric nursing, especially in trauma care, for understanding patients' psychosocial needs, tailoring follow-up plans, and promoting a patient-centred approach.
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Affiliation(s)
- Bronwyn R Griffin
- Menzies Health Institute Queensland, Griffith University, Nathan Campus, QLD, Australia; Children's Health Queensland Hospital and Health Service, Brisbane, QLD, Australia
| | - Kate Trenoweth
- Children's Health Queensland Hospital and Health Service, Brisbane, QLD, Australia
| | - Tanesha A Dimanopoulos
- Menzies Health Institute Queensland, Griffith University, Nathan Campus, QLD, Australia; Children's Health Queensland Hospital and Health Service, Brisbane, QLD, Australia.
| | - Alexandra C De Young
- Queensland Centre for Perinatal and Infant Mental Health, Children's Health Queensland, Hospital Health Service, Brisbane, QLD, Australia; Child Health Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Vanessa E Cobham
- School of Psychology, The University of Queensland, Brisbane, QLD, Australia; Child and Youth Mental Health Service, Children's Health Queensland, Brisbane, QLD, Australia
| | - Hayley Williams
- Child Health Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Roy Kimble
- Children's Health Queensland Hospital and Health Service, Brisbane, QLD, Australia
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Koh JSK, Ng ZM, Feng JXY, Badron J, Chiang LW, Ang ASY, Chong SL. Caregiver reported long-term outcomes in children with major trauma and traumatic brain injuries: A single-centre retrospective study. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2024; 53:15-22. [PMID: 38920211 DOI: 10.47102/annals-acadmedsg.202387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/27/2024]
Abstract
Introduction We aim to investigate the functional outcomes and long-term health-related quality of life (HRQOL) in children with major trauma associated with traumatic brain injury (TBI). Method We performed a retrospective review of records among patients >2 and ≤16 years old in a tertiary paediatric hospital between January 2014 and October 2019 with major trauma (Injury Severity Score of ≥16) and TBI of all severities. We recorded each child's Glasgow Outcome Scale-Extended Pediatric Version (GOS-E Peds) at 12 months post-injury and Pediatric Quality of Life Inventory (PedsQL) scores at 6 and 12 months post-injury based on the parent proxy-report scales. Results We included 53 patients with a median age of 9.0 years old (interquartile range 2.3-15.5). Most injuries were due to falls (30, 56.6%) or road traffic collisions (15, 28.3%); 41 patients (77.3%) required intensive care while 30 patients (56.6%) underwent neurosurgical intervention. Most patients (43, 81.1%) had GOS-E Peds scores of ≤2 at 12 months post-injury. We reported a significant mean difference between the 6- and 12-month parent-reported scores for physical functioning (6.6, 95% confidence interval [CI] 0.3-12.8, P=0.041), psychosocial functioning (4.1, 95% CI 1.0-7.2, P=0.012) and overall scores (5.0, 95% CI 1.4-8.7, P=0.008). Compared with the validated PedsQL scores, our mean scores were higher across all domains at 12 months. Conclusion With current standard of care, parents of children with major trauma and TBI reported gains in quality of life, physical, psychosocial and overall function between 6 and 12 months post-injury.
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Affiliation(s)
- Joel Song Kai Koh
- Department of Emergency Medicine, KK Women's and Children's Hospital, Singapore
| | - Zhi Min Ng
- Department of Paediatrics, KK Women's and Children's Hospital, Singapore
| | - Jasmine Xun Yi Feng
- Department of Emergency Medicine, KK Women's and Children's Hospital, Singapore
| | - Junaidah Badron
- Department of Emergency Medicine, KK Women's and Children's Hospital, Singapore
| | - Li Wei Chiang
- Department of Paediatric Surgery, KK Women's and Children's Hospital, Singapore
| | - Angelina Su Yin Ang
- Department of Emergency Medicine, KK Women's and Children's Hospital, Singapore
| | - Shu-Ling Chong
- Department of Emergency Medicine, KK Women's and Children's Hospital, Singapore
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Choi J, Park E, Choi AY, Son MH, Cho J. Incidence and Mortality Trends in Critically Ill Children: A Korean Population-Based Study. J Korean Med Sci 2023; 38:e178. [PMID: 37309697 DOI: 10.3346/jkms.2023.38.e178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 02/24/2023] [Indexed: 06/14/2023] Open
Abstract
BACKGROUND Monitoring mortality trends can help design ways to improve survival, but observation of national mortality trends in critically ill children is lacking for the Korean population. METHODS We analyzed the incidence and mortality trends of children younger than 18 years admitted to an intensive care unit (ICU) from 2012 to 2018 using the Korean National Health Insurance database. Neonates and neonatal ICU admissions were excluded. Multivariable logistic regression analyses were performed to estimate the odds ratio of in-hospital mortality according to admission year. Trends in incidence and in-hospital mortality of subgroups according to admission department, age, presence of intensivists, admissions to pediatric ICU, mechanical ventilation, and use of vasopressors were evaluated. RESULTS The overall mortality of critically ill children was 4.4%. There was a significant decrease in mortality from 5.5% in 2012 to 4.1% in 2018 (P for trend < 0.001). The incidence of ICU admission in children remained around 8.5/10,000 population years (P for trend = 0.069). In-hospital mortality decreased by 9.2% yearly in adjusted analysis (P < 0.001). The presence of dedicated intensivists (P for trend < 0.001, mortality decrease from 5.7% to 4.0%) and admission to pediatric ICU (P for trend < 0.001, mortality decrease from 5.0% to 3.2%) were associated with significant decreasing trends in mortality. CONCLUSION Mortality among critically ill children improved during the study period, and the improving trend was prominent in children with high treatment requirements. Varying mortality trends, according to ICU organizations, highlight that advances in medical knowledge should be supported structurally.
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Affiliation(s)
- Jaeyoung Choi
- Department of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Esther Park
- Department of Pediatrics, Jeonbuk National University Children's Hospital, Jeonju, Korea
| | - Ah Young Choi
- Department of Pediatrics, Chungnam National University Hospital, Daejeon, Korea
| | - Meong Hi Son
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Joongbum Cho
- Department of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
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Vidal AVB, de Oliveira AJM, Rossi TN, de Carvalho BCN, Volpiane MPF, Scholobach MC, Peterlini FL, dos Santos Silva RP, Nascimento FC, Gouveia EE. Surgical management of severe pediatric blunt abdominal trauma. Clin Case Rep 2023; 11:e6797. [PMID: 36694662 PMCID: PMC9842870 DOI: 10.1002/ccr3.6797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 11/26/2022] [Accepted: 12/14/2022] [Indexed: 01/18/2023] Open
Abstract
A 3-year-old male patient was brought to the Emergency Department with a traumatic blunt lesion in the liver. Due to hemodynamic instability and a severe lesion of a grade IV liver injury shown on the CT, the chosen conduct was to perform a hepatorrhaphy with oxidized cellulose.
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Affiliation(s)
| | | | - Thais N. Rossi
- Pediatric Sugery DepartmentHospital Geral de PedreirasSão PauloBrazil
| | | | | | - Max C. Scholobach
- Pediatric Sugery DepartmentHospital Geral de PedreirasSão PauloBrazil
| | | | | | | | - Edna E. Gouveia
- American University of the Caribbean School of MedicineSt. MaartenNetherlands Antilles
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Killien EY, Zahlan JM, Lad H, Watson RS, Vavilala MS, Huijsmans RLN, Rivara FP. Epidemiology and outcomes of multiple organ dysfunction syndrome following pediatric trauma. J Trauma Acute Care Surg 2022; 93:829-837. [PMID: 35358103 PMCID: PMC9525450 DOI: 10.1097/ta.0000000000003616] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Existing studies have found a low prevalence of multiple organ dysfunction syndrome (MODS) in pediatric trauma patients, typically applying adult criteria to single-center pediatric cohorts. We used pediatric criteria to determine the prevalence, risk factors, and outcomes of MODS among critically injured children in a national pediatric intensive care unit (PICU) database. METHODS We conducted a retrospective cohort study of PICU patients 1 month to 17 years with traumatic injury in the Virtual Pediatric Systems, LLC database from 2009 to 2017. We used International Pediatric Sepsis Consensus Conference criteria to identify MODS on Day 1 of PICU admission and estimated the risk of mortality and poor functional outcome (Pediatric Overall/Cerebral Performance Category ≥3 with ≥1 point worsening from baseline) for MODS and for each type of organ dysfunction using generalized linear Poisson regression adjusted for age, comorbidities, injury type and mechanism, and postoperative status. RESULTS Multiple organ dysfunction syndrome was present on PICU Day 1 in 23.1% of 37,177 trauma patients (n = 8,592), with highest risk among patients with injuries associated with drowning, asphyxiation, and abuse. Pediatric intensive care unit mortality was 20.1% among patients with MODS versus 0.5% among patients without MODS (adjusted relative risk, 32.3; 95% confidence interval, 24.1-43.4). Mortality ranged from 1.5% for one dysfunctional organ system to 69.1% for four or more organ systems and was highest among patients with hematologic dysfunction (43.3%) or renal dysfunction (29.6%). Death or poor functional outcome occurred in 46.7% of MODS patients versus 8.3% of patients without MODS (adjusted relative risk, 4.3; 95% confidence interval 3.4-5.3). CONCLUSION Multiple organ dysfunction syndrome occurs more frequently following pediatric trauma than previously reported and is associated with high risk of morbidity and mortality. Based on existing literature using identical methodology, both the prevalence and mortality associated with MODS are higher among trauma patients than the general PICU population. Consideration of early organ dysfunction in addition to injury severity may aid prognostication following pediatric trauma. LEVEL OF EVIDENCE Prognostic and Epidemiological; Level III.
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Affiliation(s)
- Elizabeth Y. Killien
- Harborview Injury Prevention and Research Center, University of Washington, Seattle, WA
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Washington, Seattle, WA
- Center for Child Health, Behavior, and Development, Seattle Children’s Research Institute, Seattle, WA
| | - Jana M. Zahlan
- Harborview Injury Prevention and Research Center, University of Washington, Seattle, WA
| | - Hetal Lad
- Harborview Injury Prevention and Research Center, University of Washington, Seattle, WA
| | - R. Scott Watson
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Washington, Seattle, WA
- Center for Child Health, Behavior, and Development, Seattle Children’s Research Institute, Seattle, WA
| | - Monica S. Vavilala
- Harborview Injury Prevention and Research Center, University of Washington, Seattle, WA
- Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA
| | - Roel L. N. Huijsmans
- Harborview Injury Prevention and Research Center, University of Washington, Seattle, WA
- University Medical Center Utrecht, Utrecht, Netherlands
| | - Frederick P. Rivara
- Harborview Injury Prevention and Research Center, University of Washington, Seattle, WA
- Center for Child Health, Behavior, and Development, Seattle Children’s Research Institute, Seattle, WA
- Division of General Pediatrics, Department of Pediatrics, University of Washington, Seattle, WA
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Reihanian Z, Noori Roodsari N, Rimaz S, Asadi P, Khoshsima N, Rafiee Zadeh A, Zia Ziabari SM, Eslami-Kenarsari H, Abbaspour E. Traumatic injuries in children during COVID-19 pandemic: a national report from northern Iran. INTERNATIONAL JOURNAL OF BURNS AND TRAUMA 2022; 12:188-193. [PMID: 36420100 PMCID: PMC9677227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Accepted: 09/14/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND There are no comprehensive and accurate statistics on epidemiology and clinical features, especially during the COVID-19 period. The present study tries to describe the pediatric traumas in a referral treatment center in northern Iran during the COVID-19 period and to compare the available statistics with the years before pandemics to examine the differences in the epidemiology of this event in our country. METHODS This cross-sectional study was performed on 543 children under 15 years admitted to this hospital due to different types of traumas in the first six months of 2019 (before the COVID-19 pandemic) and the first six months of 2020 (coinciding with the peak of the pandemic). The information was retrospectively collected by reviewing the hospital recorded files and the trauma-specific hospital information system. RESULTS In total, 436 children were referred before the COVID-19 pandemic period and 107 within the pandemic outbreak. The peak age of patients admitted was 2 to 6 years (32.0%) and 70.5% were male. Most of the pointed children had normal weight. The most common mechanism of trauma before and during the COVID-19 pandemic was falling from a height (46.3% versus 42.1%), followed by road accidents (35.6% versus 36.4%). The overall prevalence of penetrating trauma was 6.9% and 9.3%. The most common body sites affected were the head and neck (32.1%) followed by extremities (before the COVID-19 period) and extremities (29.0%) followed by the head and neck (24.3%) (in the COVID-19 period). The overall rates of multiple trauma before and within the pandemic were also 35.6% versus 35.5%. In children aged 12 to 15 years, road accidents were more reported during the COVID-19 pandemic period (68.4% versus 50.9%) and contrarily falling from a height more before the pandemic (25.5% versus 0.0%). In children under two years of age, head and neck trauma was more reported before the COVID-19 period than in the COVID-19 period (55.6% versus 35.5%), while at this age, limb trauma was more common during the COVID-19 period than before (5.6% versus 20.8%) (P = 0.043). In lean children, abdominal and pelvic trauma were mainly seen in the COVID-19 period (28.6% versus 2.6%) (P = 0.035). CONCLUSION Referrals of children from traumatic injuries decreased during the COVID-19 period. However, the main differences in the mechanism of trauma and the type and severity of traumatic injuries to children in this period emphasize the provision of specific guidelines for trauma management in children.
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Affiliation(s)
- Zoheir Reihanian
- Road Trauma Research Center, Department of Neurosurgery, School of Medicine, Guilan University of Medical SciencesRasht, Iran
| | - Nazanin Noori Roodsari
- Clinical Research Development Unit of Poursina Hospital, Department of Emergency Medicine, School of Medicine, Guilan University of Medical SciencesRasht, Iran
| | - Siamak Rimaz
- Guilan Road Trauma Research Center, Guilan University of Medical SciencesRasht, Iran
| | - Payman Asadi
- Department of Emergency Medicine, School of Medicine, Guilan University of Medical SciencesRasht, Iran
| | - Naghmeh Khoshsima
- Department of Neurosurgery, School of Medicine, Guilan University of Medical SciencesRasht, Iran
| | | | - Seyyed Mahdi Zia Ziabari
- Department of Emergency Medicine, School of Medicine, Guilan University of Medical SciencesRasht, Iran
| | - Habib Eslami-Kenarsari
- MSc in Biostatistics, Vice-chancellor for Resaerch and Technology, Guilan University of Medical SciencesRasht, Iran
| | - Elahe Abbaspour
- Guilan Road Trauma Research Center, Guilan University of Medical SciencesRasht, Iran
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Dagnaw Y, Fenta B, Yetwale A, Biyazin T, Sayih A, Dessalegn N, Adugnaw E, Ali F, Tesfa Y. Mechanisms, Pattern and Outcome of Pediatrics Trauma At Agaro General Hospital, Southwest Ethiopia, 2021. Health Serv Res Manag Epidemiol 2022; 9:23333928221101975. [PMID: 35633833 PMCID: PMC9130848 DOI: 10.1177/23333928221101975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Revised: 04/26/2022] [Accepted: 04/29/2022] [Indexed: 11/16/2022] Open
Abstract
Introduction Over 80% of trauma related deaths in children occur in low income and middle-income countries including Ethiopia. Trauma affects several aspects of child life and is still a major concern. Despite the Ethiopian federal ministry of health (FMoH) conducting away different trials, there was an increased burden and high projection of pediatric trauma. In Ethiopia, There is insufficient evidence about the mechanisms, patterns and outcomes of pediatric trauma including this study area, Therefore this study aimed to assess the mechanisms, patterns, and outcomes of pediatric trauma in Agaro General Hospital, Southwest Ethiopia, 2021. Methods and Materials This cross-sectional study was study conducted on randomly selected 405pediatric patients who visited the Agaro General Hospital between 1/1/2018 and 30/8/2021. Data were extracted from each medical chart using a structured checklist. Data were entered into Epi-data 4.4.2.1for cleaning and analyzed using SPSS version 24. Tables, charts, and text are used to report the results. Results A total of 405 patients were included in the study. This study revealed that majority 271 (66.9%) of injured children were males. Most 188 (46.4%) of the traumas were occurred on the street. Fall down injury were the most common 151(37.3%) cause of trauma, followed by road traffic accidents 98 (24.2%). Trauma caused by falls accounted for 43.7% and 34.4% % of all traumas in the 5–12 year and the <5 year age groups respectively. Most 126 (31.1%) of the subjects were exposed to head and face trauma. Majority 256 (63.2%) of children were discharged with improvement, while12 (3.0%) of them have died. Conclusions Pediatric trauma remains a major public health concern. Most of trauma occurred among boys and falldown injury was the most frequent trauma, and the majority of the subjects were exposed to head and face trauma. Therefore, children should receive safety precautions, more supervision, and identification of specific risk factors for these injuries, and should be prohibited from risky practices by concerned bodies including families and traffic officers.
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Affiliation(s)
- Yalemtsehay Dagnaw
- Department of Nursing, Mizan Tepi University, Mizan Teferi, South West Region, Ethiopia
| | - Belete Fenta
- School of Midwifery, Jimma University, Jimma, Oromia Regional State, Ethiopia
| | - Aynalem Yetwale
- School of Midwifery, Jimma University, Jimma, Oromia Regional State, Ethiopia
| | - Tsegaw Biyazin
- School of Midwifery, Jimma University, Jimma, Oromia Regional State, Ethiopia
| | - Alemayehu Sayih
- Department of Nursing, Mizan Tepi University, Mizan Teferi, South West Region, Ethiopia
| | - Nigatu Dessalegn
- Department of Nursing, Mizan Tepi University, Mizan Teferi, South West Region, Ethiopia
| | - Emebet Adugnaw
- Department of Nursing, Mizan Tepi University, Mizan Teferi, South West Region, Ethiopia
| | - Fatuma Ali
- Department of Nursing, Mizan Tepi University, Mizan Teferi, South West Region, Ethiopia
| | - Yitbarek Tesfa
- Department of Nursing, Mizan Tepi University, Mizan Teferi, South West Region, Ethiopia
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Özcan S, Gunes MSA, Havan M, Perk O, Azapağası E, Gün E, Botan E, Ergun E, Ates U, Kahilogullari G, Kendirli T. Comparison of pre-PICU and per-PICU interventions, clinical features and neurologic outcomes of motor vehicle collision trauma and other mechanisms of trauma in children. ULUS TRAVMA ACIL CER 2022; 28:456-463. [PMID: 35485520 PMCID: PMC10443131 DOI: 10.14744/tjtes.2022.86617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 01/27/2022] [Indexed: 11/20/2022]
Abstract
BACKGROUND Motor vehicle collisions (MVCs) are the number one cause of death in the pediatric age group. The aim of this study was to determine the differences between MVCs and other trauma mechanisms (OTMs) in patients who were followed up at a pediatric intensive care unit (PICU). METHODS Data were retrospectively collected for pediatric trauma patients hospitalized at a third level PICU between 2014 and 2018. Patients have been divided into two groups as MVC and OTM. Demographic data, pre-PICU interventions (cardiopulmonary resuscitation, intubation, injury severity scores, time period before intensive care), intensive care interventions (invasive mechanical ventilation, non-invasive mechanical ventilation, need for surgery, type of surgery, need for transfusion, and inotrope therapy) were compared between two groups. Outcomes were evaluated by survival, discharge from hospital, Pediatric Cerebral Performance Cate-gory (PCPC) at discharge, tracheotomy presence, and amputation performed. RESULTS During the 5-year study period, 135 patients were hospitalized for trauma. The injured body regions were the head and neck (61.5%), abdomen and lumbar spine (39.4%), and extremities and pelvis (36.3%). Multiple trauma was mostly seen in the MVC trauma group (p=0.001). The need for invasive mechanical ventilation and inotrope therapy was greater in the MVC group (p=0.002, 0.001 respectively). One hundred and twenty-three patients (91.1%) survived. The mortality rate was higher in the MVC group (p=0.026). The PCPC results were better in the OTM group (p=0.017). CONCLUSION MVCs lead to more multiple trauma cases than OTMs. Invasive mechanical ventilation, inotropes, and other inten-sive care interventions were necessary much more often in MVC victims than in OTM patients.
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Affiliation(s)
- Serhan Özcan
- Department of Pediatric Critical Care Medicine, Ankara University Faculty of Medicine, Ankara-Turkey
| | | | - Merve Havan
- Department of Pediatric Critical Care Medicine, Ankara University Faculty of Medicine, Ankara-Turkey
| | - Oktay Perk
- Department of Pediatric Critical Care Medicine, Ankara University Faculty of Medicine, Ankara-Turkey
| | - Ebru Azapağası
- Department of Pediatric Critical Care Medicine, Ankara University Faculty of Medicine, Ankara-Turkey
| | - Emrah Gün
- Department of Pediatric Critical Care Medicine, Ankara University Faculty of Medicine, Ankara-Turkey
| | - Edin Botan
- Department of Pediatric Critical Care Medicine, Ankara University Faculty of Medicine, Ankara-Turkey
| | - Ergun Ergun
- Department of Pediatric Surgery, Ankara University Faculty of Medicine, Ankara-Turkey
| | - Ufuk Ates
- Department of Pediatric Surgery, Ankara University Faculty of Medicine, Ankara-Turkey
| | - Gokmen Kahilogullari
- Department of Neurosurgery, Ankara University Faculty of Medicine, Ankara-Turkey
| | - Tanıl Kendirli
- Department of Pediatric Critical Care Medicine, Ankara University Faculty of Medicine, Ankara-Turkey
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Kuok CI, Chan WKY, Kwok AWL. What and who should we focus in pediatric injury prevention - An analysis of critical pediatric trauma in a major trauma center in Hong Kong. Pediatr Neonatol 2021; 62:620-627. [PMID: 34330685 DOI: 10.1016/j.pedneo.2021.05.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 04/18/2021] [Accepted: 05/20/2021] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND Understanding trauma epidemiology is essential in formulating region-specific strategies for injury prevention. Our study aimed to evaluate the characteristics and clinical outcomes of critical pediatric trauma requiring intensive care in Hong Kong. METHODS A retrospective analysis was performed on pediatric patients who were injured and admitted to the pediatric intensive care unit (PICU), Queen Elizabeth Hospital, Hong Kong between 2014 and 2018. Clinical features of patients who sustained injuries before and after 2 years old were compared. RESULTS 141 patients were admitted to the PICU due to trauma during the study period. Most patients sustained injuries due to fall (48.2%) or road traffic injuries (34.0%), with the latter more common in older patients. Two (1.4%) patients died due to the trauma. The majority (95.0%) of the survivors had good recovery assessed by Glasgow Outcome Scale. Patients younger than 2 years old were mostly injured at home due to fall while left unattended. Children in this age group were more likely to receive interventions, including mechanical ventilation (OR 2.61; 95% CI 1.15-5.95), anti-epileptic medications (OR 2.61; 95% CI 1.17-5.83), blood transfusion (OR 5.37; 95% CI 2.29-12.60) and inotropic support (OR 4.08; 95% CI 1.31-12.70), and require longer hospitalization (PICU stay 2.5 vs. 1.5 days, p = 0.011; hospital stay 10.9 vs. 6.9 days, p = 0.012). CONCLUSION Fall injuries and road traffic injuries were common etiologies of critical pediatric trauma in Hong Kong. Patients younger than 2 years old had worse clinical outcomes. Parental education on home safety and importance of close supervision should be emphasized in this age group.
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Affiliation(s)
- Chon In Kuok
- Department of Paediatrics, Queen Elizabeth Hospital, Hong Kong.
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Delayed presentation of traumatic hepatic pseudoaneurysm in a child. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2020. [DOI: 10.1016/j.epsc.2020.101452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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