First step to a better pediatric trauma management: The first results of Northern Izmir Trauma Registry System

Abstract

BACKGROUND:Trauma is an important health problem in children, and improvement in trauma care on the national level is possible only through the knowledge gathered from trauma registry systems. This information is not available in our country, because there is no current trauma registry system in the hospitals. Our aim in this paper is to explain the trauma registry system we have developed and to present the first year's data. METHODS:The planned trauma registry system was integrated into the emergency department registry system of 14 hospitals in the Izmir province. The data of pediatric patients with multiple trauma have been recorded automatically through the registry system. Demographics, vital signs, mechanism, the type of trauma, anatomical region, Injury Severity Score (ISS), Pediatric Trauma Score (PTS), Glasgow Coma Scale (GCS) score, the length of hospital stay, and the need for blood transfusion/endotracheal intubation/surgery/ hospitalization were evaluated by the patient transfer status and outcome. RESULTS:At the end of one year, a total of 356 pediatric major trauma patients were included in the study. The most common type of trauma was blunt trauma (91.9%), and the most common mechanism was vehicle-related traffic accident (28.1%). In the group with the Glasgow Outcome Scale ≤3; the age was greater, ISS was higher, and PTS was lower. Motorcycle accidents, sports injuries, and penetrating injuries were more frequent in this group. All scores were significantly different between direct and transferred patients. The referral time to the hospital of the transferred patients was longer than directly admitted patients, but the results were not different. CONCLUSION:Pediatric major trauma is an important cause of mortality and morbidity, and our trauma registry system, which is a successful example abroad, is insufficient in our country. We hope that the trauma registry system we planned and the pilot application we started will be expanded to include other hospitals throughout the country with the aim of developing a national registry system.

Evaluation of Critically Ill Paediatric Patients in the Adult ICU

“…In this recent study, lower age, higher PRISM-III and PELOD-II scores, higher dosages of vasopressor/inotropic support during the first 24 hours, prolonged MV duration, greater requirement of blood product transfusion, presence of trauma, nosocomial infection, VAP, thrombocytopenia, lower MAP and haemoglobin values, and leuko- cytosis during the first 24 hours were to be found mortality risk factors. Similar to other studies, in the present study, the mean age of the patients cared for in the aICU was (7.4 ± 5.4) years (10)(11)(12). The length of stay in the pICU was generally between 2 and 9.7 days in previous studies; it was similarly 6.6 ± 14.2 days in the present study (13)(14)(15).…”

Evaluation of Pediatric Trauma Patients Requiring Pediatric Intensive Care Follow-up and Identifying the Differences in Refugee Children

“…In our study, we examined the characteristics of trauma patients followed up in our reference tertiary hospital PICU. Oztan et al (9) reported the median age as 6 years in a study on pediatric trauma patients (2)(3)(4)(5)(6)(7)(8)(9)(10)(11). In another study evaluating Turkish citizens and refugee patients followed up for trauma, the median age was found to be 8 and 9 years, respectively (8).…”

“…In the literature, it has been reported that men have a higher propensity for traumatic injury than women and a higher incidence of death due to traumatic injury (10,11,20). Mortality rates of pediatric trauma patients vary between 0.5% and 30% in European countries (9,10,14,21). It has been determined that the most common cause of fatal injuries in children is motor vehicle accidents (22,23).…”