Comparison of multiple trauma in children and adults

Abstract

Multiple injuries in children are responsible for a great part of childhood mortality. Remaining handicaps after injuries have a social and economic significance. In this study, the characteristics of polytrauma in childhood are evaluated by comparison with severely injured adults. The two groups of multiple trauma patients (117 children between 3 and 15 years of age and 1159 adults between 16 and 59) were equal in the overall severity of all injuries. Children were mainly hurt as pedestrians, whereas adults had an accident more often as car passengers. The most frequently injured region were in both groups fractures of the extremities. The greatest injury severity represented head injuries in each group. Complications were seen more often in adult patients. Multiple organ failure and isolated liver failure were exclusively seen in the adult group, pneumonia and lung failure occurred significantly more often. The duration of artificial ventilation and the duration of hospital stay were prolonged in the adult group. In summary, children with multiple injuries have a lower mortality rate than adults. The main cause of death are cerebral injuries. Remaining handicaps in surviving children are most often caused by fractures of the lower extremities.

Pädiatrische Notfälle in der präklinischen Notfallmedizin

“…Hierbei fanden sich in unserer Arbeit keine Unterschiede zwischen Patienten der Luftrettung und des bodengebundenen Rettungsdienstes. Andere Studien aus Klinik [18,24,30] Schädel-Hirn-Traumen sind nicht nur häufig, sondern stellen besonders im Luftrettungskollektiv über alle Altersgruppen den größten Anteil an schweren Verletzungen dar [1,13,36], die oft über die weitere Prognose des verunfallten Kindes entscheiden [18].…”

“…Während Extremitätentrau-men fast ausschließlich als "leicht" oder "mittelschwer" eingeordnet werden, sind Verletzungen von Thorax-und Abdomen oft schwer und treten wegen der engen räumlichen Beziehungen gerade bei kleineren Kindern oft als Kombinationsverletzungen (Torso-oder Rumpftrauma) auf. Diese Ergebnisse werden von anderen Autoren bestätigt [ [13], in deren Untersuchung Rumpfverletzungen noch häufiger auftraten als Extremitätentraumen, weisen darauf hin, dass Thoraxverletzungen im Kindesalter zwar signifikant seltener zu beobachten sind als im Erwachsenenalter [24], dass sie jedoch häufig Ausdruck einer schweren Gesamtverletzung des Kindes sind und daher als "Leitverletzung" für kindliche Polytraumen gelten können.…”

Comparison of transportation related injury mechanisms and outcome of young road users and adult road users, a retrospective analysis on 24,373 patients derived from the TraumaRegister DGU®

“…Bayreuther et al found a decline in the proportion of children with head injuries and an increase in the proportion with limb injuries with increasing age [17]. Reichmann et al also showed similar results [17, 18].…”

Incidence and Prognosis of Organ Failure in Severely Injured Children and Adult Patients

“…Several studies suggest that there seems to exist a "48 h border" for children. As soon as they survive this time period, they have a much better prognosis than adults [8,29].…”

“…The manifestation of SOF and MOF is significantly correlated with the initial shock and the resulting reperfusion [11,29]. Due to hypoxia, ischemia and reperfusion, damages can occur.…”