Predictors for moderate to severe paediatric head injury derived from a surveillance registry in the emergency department

Chong, Shu-Ling; Barbier, Sylvaine; Liu, Nan; Ong, Gene Yong-Kwang; Ng, Kee Chong; Ong, Marcus Eng Hock

doi:10.1016/j.injury.2015.04.002

Cited by 9 publications

(12 citation statements)

References 21 publications

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“…In view of mechanism, fall injuries, scald by hot liquid and substance and traffic related incidences were found to be a concern for further exploration and prevention There were more scald injury happened in the aged below 2 years. Similar to western study that motor vehicle traffic injury resulted in the most severe injury, 24,25 there was increased number of traffic injured with ages. For the temporal consideration, steady observation was made along the temporal features including year, month, weekday and seasons.…”

Section: Main Findingssupporting

confidence: 62%

Epidemiology of paediatric trauma in Hong Kong: A multicentre cohort study

Chow

Leung²,

Leung

et al. 2019

Clinical Epidemiology and Global Health

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Introduction: Trauma is the commonest cause of death and major morbidities in children and adolescents worldwide. There has been a lack of data on the epidemiology of trauma among children in Chinese cities include Hong Kong. Therefore the current study was conducted to examine the spectrum of paediatric trauma in Hong Kong and to address knowledge gaps in its epidemiology and prevention. Objective: This study aimed to describe the epidemiological features of paediatric trauma and explore the characteristics in the low income group which would help to guide the design of effective interventions and future research on prevention of paediatric trauma. Method: A descriptive study on the epidemiology of trauma in children ≤18-year-old using a standardised injury registry embedded within a population-based hospital database. Information on demographics, injury type, mechanism, injury severity score (ISS) and injury prevention prioritization score (IPPZ) were collected to identify the epidemiological features and prevention initiatives. Result: The overall female to male ratio was 1: 1.97, which increased with age from 1:1.45 (infant; below 2 years old) to 1:2.67 (adolescent; 12-18 years old). The overall mean ISS was 7.98 (SD 9.18), ISS increased with age significantly (rho = 0.143, P < 0.001). The most common context of trauma included travelling (IPPZ: 59.94, mean ISS 10.2 ± 10.23, n = 402), leisure activities (IPPZ: 52.04, mean ISS 5.6 ± 6.77, n = 312), street/ highway (IPPZ: 70.22, mean ISS 10.48 ± 10.53, n = 475) and home (including garden and out buildings) (IPPZ: 69.56, mean ISS 6.64 ± 7.94, n = 539). Severity of paediatric injuries among low-income group did not differ from the general population. Conclusion: The study provided updated epidemiological characteristics of paediatric trauma, which could be used to guide focus prevention of paediatric trauma. The findings also highlighted further study initiatives including injury surveillance, geographical analysis and environment modification.

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Section: Main Findingssupporting

confidence: 62%

Epidemiology of paediatric trauma in Hong Kong: A multicentre cohort study

Chow

Leung²,

Leung

et al. 2019

Clinical Epidemiology and Global Health

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“…Most of the injuries presented at the ED, involved injuries sustained at home (52.2%–56.4%) [ 9 , 19 ]. Falls were implicated in 49%–71.8% of the ED attendances [ 9 , 19 , 31 ]. A retrospective study involving 2517 children aged 12 years and younger presenting to an ED over one year duration noted that there was a high incidence of injuries sustained at home (56.4%) compared to other mechanisms of injury.…”

Section: Resultsmentioning

confidence: 99%

“…Falls was noted to be the main mechanism of injury (49%) but no significant association was found with the median height of the fall ( p = 0.069). The investigators also concluded that four predictors of moderate to severe head injury was significant; namely: mechanism of road traffic accident (Adjusted OR 10.9, p < 0.001), difficult arousal (Adjusted OR 107.6, p < 0.001), vomiting (Adjusted OR 5.4, p = 0.003) and signs of base of skull fracture (Adjusted OR 44.1, p < 0.001) [ 31 ].…”

Section: Resultsmentioning

confidence: 99%

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Childhood Injuries in Singapore: Can Local Physicians and the Healthcare System Do More to Confront This Public Health Concern?

Ong

Low

Vasanwala

2016

IJERPH

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Childhood injury is one of the leading causes of death globally. Singapore is no exception to this tragic fact, with childhood injuries accounting up to 37% of Emergency Department visits. Hence, it is important to understand the epidemiology and risk factors of childhood injuries locally. A search for relevant articles published from 1996–2016 was performed on PubMed, Cochrane Library and Google Scholar using keywords relating to childhood injury in Singapore. The epidemiology, mechanisms of injury, risk factors and recommended prevention strategies of unintentional childhood injuries were reviewed and described. Epidemiological studies have shown that childhood injury is a common, preventable and significant public health concern in Singapore. Home injuries and falls are responsible for majority of the injuries. Injuries related to childcare products, playground and road traffic accidents are also important causes. Healthcare professionals and legislators play an important role in raising awareness and reducing the incidence of childhood injuries in Singapore. For example, despite legislative requirements for many years, the low usage of child restraint seats in Singapore is worrisome. Thus, greater efforts in public health education in understanding childhood injuries, coupled with more research studies to evaluate the effectiveness and deficiencies of current prevention strategies will be necessary.

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“…The causes of injuries among this patient population in Singapore are largely consistent with prior reports. 16 While falls are common, road traffic accidents tend to be associated with larger forces and more severe injuries. Our study showed that this effect was evident regardless of age or location of injury.…”

Section: Discussionmentioning

confidence: 99%

A prospective surveillance of paediatric head injuries in Singapore: a dual-centre study

et al. 2016

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ObjectiveTo study the causes of head injuries among the paediatric population in Singapore, and the association between causes and mortality, as well as the need for airway or neurosurgical intervention.DesignThis is a prospective observational study utilising data from the trauma surveillance system from January 2011 to March 2015.SettingPaediatric emergency departments (EDs) of KK Women's and Children's Hospital and the National University Health System.ParticipantsWe included children aged <16 years presenting to the paediatric EDs with head injuries who required a CT scan, admission for monitoring of persistent symptoms, or who died from the head injury. We excluded children who presented with minor mechanisms and those whose symptoms had spontaneously resolved.Primary and secondary outcome measuresPrimary composite outcome was defined as death or the need for intubation or neurosurgical intervention. Secondary outcomes included length of hospital stay and type of neurosurgical intervention.ResultsWe analysed 1049 children who met the inclusion criteria. The mean age was 6.7 (SD 5.2) years. 260 (24.8%) had a positive finding on CT. 17 (1.6%) children died, 52 (5.0%) required emergency intubation in the ED and 58 (5.5%) underwent neurosurgery. The main causes associated with severe outcomes were motor vehicle crashes (OR 7.2, 95% CI 4.3 to 12.0) and non-accidental trauma (OR 5.8, 95% CI 1.8 to 18.6). This remained statistically significant when we stratified to children aged <2 years and performed a multivariable analysis adjusting for age and location of injury. For motor vehicle crashes, less than half of the children were using restraints.ConclusionsMotor vehicle crashes and non-accidental trauma causes are particularly associated with poor outcomes among children with paediatric head injury. Continued vigilance and compliance with injury prevention initiatives and legislature are vital.

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Predictors for moderate to severe paediatric head injury derived from a surveillance registry in the emergency department

Cited by 9 publications

References 21 publications

Epidemiology of paediatric trauma in Hong Kong: A multicentre cohort study

Epidemiology of paediatric trauma in Hong Kong: A multicentre cohort study

Childhood Injuries in Singapore: Can Local Physicians and the Healthcare System Do More to Confront This Public Health Concern?

A prospective surveillance of paediatric head injuries in Singapore: a dual-centre study

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