Causes and Outcomes of Childhood Trauma with GCS Below 9

Year 2022, Volume: 4 Issue: 2, 29 - 33, 31.08.2022

Changiz Gholipouri Samad Shams Vahdati Parham Maroufi Aytak Khabbaz Naeimeh Hosseinzadeh Pouya Abbasgholizadeh

https://doi.org/10.55994/ejcc.1047577

Abstract

Background: Trauma, as one of the major public health challenges, was the leading cause of death and disability in most countries. Trauma was considered as the most common reason for emergency department admission. Children are the most susceptible group of society to trauma, so we designed a study to investigate the epidemiologic feature and outcomes of trauma in children under 18 years old. In light of these findings, we might be able to prevent trauma in children.
Materials and methods: We conducted a retrospective cross-sectional study during the spring season of 2019 (for 3 months). The study population was all children under eighteen years old with GCS below 9 (1814cases), referring to the emergency department of Tabriz Emam-Reza Hospital. Among 1814 patients, 1786 patients were included. For each included patient, the outcomes of the 24-hour follow-up have been recorded.
Result: In this study, 62.1% percent (n=1109) were males. The mean age of patients was 5.47 ± 3.1. There were 1271 (71.1%) head and neck trauma, 276 (15.5%) extremities trauma. Abdominal trauma (n=66, 3.7%) and spinal trauma (n=57, 3.2%) were the rarest types of mechanism. It was revealed that falling had the most incidence frequency (40.4%). Eventually, out of the entire study population, 1361 patients were discharged from the emergency department (75%), 5 patients transferred to the trauma ward (0.2%), 1 patient hospitalized in the intensive care unit (0.05%), 250 patients left the hospital against physician permission (14%), 110 patients referred to another center (6%), 59 patients escaped from the hospital (3%) and zero deaths.
Conclusion: Our study suggests that the head and neck were the most injured anatomic locations in children. Males were more susceptible to being exposed to trauma. Falling and traffic accidents were the most frequent mechanism of trauma that occurred in under eighteen-year-old children. Awareness of patterns of pediatric trauma may help the adoption of safety policies and develop prevention strategies. In this regard, training prevention strategies for parents and improving playground safety will be effective.

Keywords

Trauma, pediatric, outcome

Supporting Institution

Emergency research team, Tabriz University of Medical Sciences

References

• 1. Jones S, Tyson S, Young M, Gittins M, Davis NJAodic. Patterns of moderate and severe injury in children after the introduction of major trauma networks. 2019;104(4):366-71.
• 2. Naranje SM, Erali RA, Warner WC, Sawyer JR, Kelly DMJJoPO. Epidemiology of pediatric fractures presenting to emergency departments in the United States. 2016;36(4):e45-e8.
• 3. Chaitanya K, Addanki A, Karambelkar R, Ranjan RJCsns. Traumatic brain injury in Indian children. 2018;34(6):1119-23.
• 4. Stephens S, Campbell R, Chaseling R, Ma NJJocn. Traumatic brain injuries in a paediatric neurosurgical unit: a Queensland experience. 2019;70:27-32.
• 5. Allen CJ, Wagenaar AE, Horkan DB, Baldor DJ, Hannay WM, Tashiro J, et al. Predictors of mortality in pediatric trauma: experiences of a level 1 trauma center and an assessment of the International Classification Injury Severity Score (ICISS). 2016;32(7):657-63.
• 6. Nabian MH, Vosoughi F, Najafi F, Khabiri SS, Nafisi M, Veisi J, et al. Epidemiological pattern of pediatric trauma in COVID-19 outbreak: Data from a tertiary trauma center in Iran. 2020;51(12):2811-5.
• 7. Coulthard MG, Varghese V, Harvey LP, Gillen TC, Kimble RM, Ware RSJPo. A review of children with severe trauma admitted to pediatric intensive care in Queensland, Australia. 2019;14(2):e0211530.
• 8. Dolatabadi AA, Mohseninia N, Amiri M, Motamed H, Asl AHJIjoem. Pediatric trauma patients in Imam Hossein emergency department; an epidemiologic study. 2016;3(1):4-8.
• 9. Aoki M, Abe T, Saitoh D, Oshima KJSr. Epidemiology, patterns of treatment, and mortality of pediatric trauma patients in Japan. 2019;9(1):1-7.
• 10. Brehaut JC, Miller A, Raina P, McGrail KMJP. Childhood behavior disorders and injuries among children and youth: a population-based study. 2003;111(2):262-9.
• 11. Bernardo LM, Gardner MJ, Seibel KJJfSiPN. Playground injuries in children: a review and Pennsylvania Trauma Center experience. 2001;6(1):11-20.
• 12. Memarzadeh M, Hoseinpour M, Sanjary N, Karimi ZJKJ. A study on trauma epidemiology in children referred to Isfahan Alzahra Hospital during 2004-7. 2011;14(5):488-93.
• 13. Chong S-L, Khan UR, Santhanam I, Seo JS, Wang Q, Jamaluddin SF, et al. A retrospective review of paediatric head injuries in Asia–a Pan Asian Trauma Outcomes Study (PATOS) collaboration. 2017;7(8):e015759.