The associations between injury mechanism and extended hospital stay among pediatric patients: findings from a trauma Center in Saudi Arabia

Abstract

Background A hospitalized patient’s length of stay (LOS) can have a significant impact on the performance and operating costs of a healthcare facility. Among pediatric patients, traumatic injuries are common causes of emergency room visits and hospitalizations. In Saudi Arabia, little is known about the burden of pediatric traumas on population health and the healthcare facilities. Therefore, the aim of this study was to investigate the associations between traumatic pediatric injury mechanisms and extended LOS in a trauma center. Methods Data was obtained from the trauma registry. From 2001 to 2018, trauma patients between the ages of 0 and 18 years old with LOSs of > 0 days were analyzed. The independent variable was the injury mechanism, which was classified as follows: falls, burns, drowning, motor vehicle collisions, motorcycle collisions, pedestrian, and intentional injuries. The dependent variable was an extended LOS defined as ≥21 days. A multivariate logistic regression analysis was used to evaluate the associations between the injury mechanisms and an extended LOS. Results A total of 5563 pediatric patients were included in this study. Of those, 774 (14%) had extended LOSs. Those patients with extended LOSs suffered more severe injuries than those with short hospital stays as measured by the Injury Severity Score (mean scores: 15.4 vs. 6.8, p < 0.01), the Glasgow Coma Scale score (mean scores: 10.4 vs, 14.0, p < 0.01), and the Revised Trauma Score (mean scores: 9.9 vs. 11.0, p < 0.01). Approximately one half of the patients with extended LOSs were admitted due to motor vehicle injuries. In addition, those patients were almost five times more likely to have extended LOSs than the patients who suffered fall injuries (odds ratio: 4.8, 95% confidence interval: 3.2–7.1). Conclusions Based on the study results, motor vehicle injuries were significantly associated with extended hospitalizations. Prevention is instrumental for reducing healthcare utilization; therefore, these findings call for public health professionals and policymakers to plan, design, and implement preventive measures to reduce the traffic injury burden. In addition, increased traffic law enforcement, such as the use of car restraints, is warranted to reduce the preventable injuries and improve the overall population health.

Assessment of Circulatory Management in Pediatric Polytrauma According to International Guidelines in Suez Canal University Hospital

“…Males formed about 60.7% of the pediatric patients in the current study which comes in accordance with much of the literature (12)(13)(14)(15) . The overrepresentation of males among trauma patients perhaps because boys are more inclined to play in hazardous environments without adult supervision.…”

Epidemiology of childhood injuries in Saudi Arabia: a scoping review

“…Furthermore, blunt injuries caused by falls and MVC were the leading cause of deaths in overall injuries [ 21 ]. Additionally, MVC was reported to be the primary cause of injury that led to an extended length of stay [ 22 ]. In fact, the mechanism of injury was found to be a significant predictor of extended length of stay with higher odds for MVC and burns (OR: 16.2, OR: 14.5, respectively, P < 0.001) as opposed to falls [ 22 ].…”

“…The leading cause of deaths among patients was blunt injury (92%). The mortality rate was 2.8% Riyadh 16 (Alghnam et al, 2019) [ 22 ] 2001 - 2018 Retrospective N=5563 Males represented 75.8% of admitted children following injuries. The most common type of injury was fall (31.5%), followed by an MVC (28.5%) The prevalence of children who had extended length of stay was 14%.…”

Drowning in the Eastern Mediterranean region: a systematic literature review of the epidemiology, risk factors and strategies for prevention

“…Included studies were published between 1975 [29] and 2021 [30][31][32]. Studies most commonly reported data on drowning from Iran (27 studies ), Saudia Arabia (11 studies [31,32,[60][61][62][63][64][65][66][67][68]) and Pakistan (10 studies [69][70][71][72][73][74][75][76][77][78]). There were 3 studies which reported on multiple countries within the EMR [79][80][81] and 3 studies which reported on the EMR as a whole [3,82,83] (Table 1).…”