Injuries Among Children and Adolescents Caused by Traffic Accidents: Prognostic Indicators and Clinical Outcomes

Yıl 2026, Cilt: 7 Sayı: 1, 102 - 119, 31.01.2026

Mustafa Oguz Cumaoglu , Abdussamed Vural , Hakan Güner , Recep Kemal Soylu , Sabri Sekme , Turkan Yildiz

https://doi.org/10.47482/acmr.1798670

Öz

Background: Traffic accidents are a major cause of morbidity and mortality in children and adolescents. Comprehensive data combining demographic, clinical, and laboratory findings in Türkiye are limited. This study aimed to evaluate epidemiology, injury distributions, laboratory results, and prognostic factors associated with clinical outcomes and mortality.
Methods: This retrospective single-center cohort included 586 patients (0–17 years) who presented to the emergency department in 2024 after traffic accidents (ICD-10 V00–V89). Demographic characteristics, mechanisms, injury sites, laboratory parameters, treatments, and outcomes were analyzed. Binary logistic regression identified factors independently associated with mortality after age adjustment.
Results: The cohort comprised 392 males (66.9%) and 194 females (33.1%) with a median age of 12 years (IQR 8–15). In-vehicle accidents (54.6%) and pedestrian injuries (24.6%) were most common. Male sex and adolescent age were associated with greater injury severity and adverse outcomes. Among laboratory parameters, only INR was significantly higher in non-survivors (median 1.18 vs 1.06; p < 0.001) and was also elevated among hospitalized and surgically treated patients. Mortality occurred in 13 patients (2.2%). Head trauma was the strongest independent predictor of death (adjusted OR 24.7; 95% CI 6.6–93.0; p<0.001), while thoracic, abdominal/pelvic, and lower-extremity injuries also increased risk.
Conclusion: Head trauma is the key determinant of mortality in pediatric traffic accidents, with male gender and adolescence conferring additional risk. Incorporating simple clinical and laboratory indicators—particularly INR—into early evaluation may enhance triage, optimize resource use, and improve outcomes. These findings highlight the importance of early identification of high-risk injury patterns in optimizing pediatric emergency management.

Anahtar Kelimeler

Accidents , adolescent , child , risk factors , traffic

Etik Beyan

The study was approved by the Non-Interventional Ethics Committee of the Faculty of Medicine, Nigde Omer Halisdemir University (Approval No: 2025/37; Date: March 25, 2025) and conducted in accordance with the principles of the Declaration of Helsinki. According to institutional regulations, informed consent was not required for retrospective studies. Permission for data access and use was obtained from the ethics committee. All patient data were anonymized prior to analysis and processed according to General Data Protection Regulation (GDPR) -compliant data protection protocols.

Destekleyen Kurum

This study has received no funding, granting or sponsorship.

Teşekkür

None.

Çocuk ve Ergenlerde Trafik Kaynaklı Yaralanmalarda Etyoloji, Yönetim ve Prognostik Faktörler

Öz

Arka Plan:
Trafik kazaları, çocuk ve ergenlerde morbidite ve mortalitenin başlıca nedenlerinden biridir. Türkiye’de demografik, klinik ve laboratuvar bulgularını bir arada değerlendiren kapsamlı veriler sınırlıdır. Bu çalışma, epidemiyolojiyi, yaralanma dağılımlarını, laboratuvar sonuçlarını ve klinik sonuçlar ile mortaliteyle ilişkili prognostik faktörleri değerlendirmeyi amaçlamıştır.

Yöntemler:
Bu retrospektif tek merkezli kohort, 2024 yılında trafik kazası (ICD-10 V00–V89) sonrası acil servise başvuran 0–17 yaş arası 586 hastayı içermektedir. Demografik özellikler, yaralanma mekanizmaları, yaralanma bölgeleri, laboratuvar parametreleri, tedaviler ve klinik sonuçlar analiz edilmiştir. İkili lojistik regresyon analizi, yaşa göre ayarlama sonrası mortalite ile bağımsız olarak ilişkili faktörleri belirlemiştir.

Bulgular:
Kohort 392 erkek (%66,9) ve 194 kız (%33,1) hastadan oluşmuştur; ortanca yaş 12 yıldır (IQR 8–15). Araç içi kazalar (%54,6) ve yaya yaralanmaları (%24,6) en sık görülen mekanizmalardı. Erkek cinsiyet ve ergenlik dönemi, daha yüksek yaralanma şiddeti ve olumsuz sonuçlarla ilişkiliydi. Laboratuvar parametreleri arasında yalnızca INR, yaşamını kaybedenlerde anlamlı derecede yüksek bulunmuştur (p<0,05) ve ayrıca hastaneye yatırılan veya cerrahi tedavi uygulanan olgularda da artmıştı. Mortalite 13 hastada (%2,2) meydana geldi. Kafa travması, ölümün en güçlü bağımsız belirleyicisi olarak saptandı (düzeltilmiş OR 24,7; %95 GA 6,6–93,0; p<0,001); torasik, abdominal/pelvik ve alt ekstremite yaralanmaları da riski artırmıştır.

Sonuç:
Kafa travması, pediatrik trafik kazalarında mortalitenin temel belirleyicisidir; erkek cinsiyet ve ergenlik ek risk faktörleri olarak öne çıkmaktadır. Özellikle INR olmak üzere basit klinik ve laboratuvar göstergelerinin erken değerlendirmeye dahil edilmesi, triyajın etkinliğini artırabilir, kaynak kullanımını optimize edebilir ve klinik sonuçları iyileştirebilir. Bu bulgular, pediatrik acil yönetiminde yüksek riskli yaralanma paternlerinin erken tanımlanmasının önemini vurgulamaktadır.

Anahtar Kelimeler

Kaza , ergen , çocuk , risk faktörleri , trafik

Kaynakça

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