Epidemiology, patterns, and mechanisms of pediatric trauma: a review of 12,508 patients

Abstract

Background Pediatric traumas are common and remain a unique challenge for trauma surgeons. Demographic data provide a crucial source of information to better understand mechanisms and patterns of injury. The aim of this study was to provide this information to improve treatment strategies of potentially preventable morbidity and mortality in children. Material and methods A retrospective review of every pediatric trauma treated in the emergency department (ED) between 2015 and 2019 was performed. Inclusion criteria were the age between 0 and 14 years and admission to the ED after trauma. Demographic data, time of presentation, mechanism of injury and pattern of injury, treatment, and outcome were analyzed. Different injury patterns were assessed in relation to age group, sex, mechanism of injury and treatment. Results A total of 12,508 patients were included in this study. All patients were stratified into five age groups: babies under the age of 1 (8.8%), toddlers between 1 and 3 (16.8%), preschool children between 4 and 6 (19.3%), young school children between 7 and 10 (27.1%), and young adolescents between 11 and 14 (27.9%). The predominant sex in all age groups was male. 47.7% of patients were admitted between 4 and 10 pm; 14.8% of the patients arrived between 10 pm and 8 am. Peak months of admissions were May to July. Overall, 2703 fractures, 2924 lacerations and superficial tissue injury, 5151 bruises, 320 joint dislocations, 1284 distortions, 76 burns, and 50 other injuries were treated. Most common mechanisms for fractures were leisure activities, falls, and sports-related activities. Forearm fractures were the most common fractures (39.5%) followed by humerus fractures (14%) and fractures of the hand (12.5%). A total of 700 patients with fractures (25.9%) needed surgery. 8.8% of all patients were hospitalized for at least one day. 4 patients died in the hospital (0.03%). Conclusion Despite of higher risk, severe injuries in children are rare. Minor injuries and single fractures are common. Treatment should be managed in specialized centers to ensure an interdisciplinary care and fast recovery. Peak times in the late afternoon and evening and summer months should be taken into consideration of personnel planning.

Management of Pancreatic and Duodenal Trauma in Childhood: A University Hospital Experience Over a Ten-Year Period

“…The epidemiology of pediatric pancreaticoduodenal trauma has not been well-studied. However, some data suggest that it accounts for less than 1% of all pediatric traumas and 2-12% of abdominal traumas in children [4,5]. In our study, trauma was more prevalent in male patients.…”

“…Abdominal trauma is children's second most common trauma site, following isolated head trauma [2,3]. Duodenal and pancreatic injuries have been reported to occur in 2-12% of children suffering from abdominal injuries [4,5]. Isolated duodenal and pancreatic injuries have been observed in approximately two-thirds of cases, while combined injuries in both organs have occurred in the remaining third [6].…”

Traumatic tension pneumomediastinum mimicking pneumothorax in a 6‐year‐old child

“…Road traffic injuries represent a major public health concern worldwide, with 186 300 children dying from this condition every year 1,2 . Tracheobronchial injuries after blunt chest trauma is an uncommon lesion in children, with an incidence of 0.5% to 2% among patients with cervicothoracic trauma 3 …”

“…Road traffic injuries represent a major public health concern worldwide, with 186 300 children dying from this condition every year. 1,2 Tracheobronchial injuries after blunt chest trauma is an uncommon lesion in children, with an incidence of 0.5% to 2% among patients with cervicothoracic trauma. 3 The signs and symptoms most commonly encountered in tracheobronchial injuries are non-specific including tachypnea, dyspnea, respiratory distress, subcutaneous emphysema, and hemoptysis.…”

The sequence of the treatment of combined fractures of the pelvis, spine, and extremities in polytraumatized patients

“…Regarding the age and gender distribution, international publications show an age peak between the 40th and 50th year of life and a predominance of the male gender (>60%). According to the literature, about 25% of severely injured PT patients are likely to have a pelvic injury, 30% spinal injury, and 65% injury of the extremity ( 1 , 2 , 3 ). However, the incidence of a combination of these injuries should be comparatively rare.…”