Evaluation of forensic cases admitted to the pediatric emergency department

Abstract

Aim: Pediatric forensic cases have an important share in pediatric emergency service admissions. These require immediate treatment as they can lead to pediatric morbidity and mortality. In this study, a retrospective analysis of pediatric patients admitted to the emergency department due to acute forensic events was performed, and it was aimed to contribute to the data collected in Turkey by evaluating the results along with the results of other studies.
Material and Method: All pediatric forensic cases admitted to the Pediatric Emergency Service of the Gülhane Training and Research Hospital between November 2016 and January 2018 were retrospectively analyzed. The demographic characteristics, forensic events, intoxication agents, hospitalization statuses and clinical follow-ups of the cases were recorded.
Results: Among the 819 pediatric forensic cases admitted to the Pediatric Emergency Service, 393 (48%) were male, and 426 (52%) were female. The cases were aged between 0 and 18, with a mean age of 7.75±6.87 years. The majority of the patients were in the 0-2 age group (n=349, 42.6%). Case admissions were more frequent in winter months (n= 240; 29.3%), and most admissions were made in December (n=92; 11.2%). The days of the week with the highest frequencies of admissions were Wednesday (n=138, 16.8%) and Monday (n=134, 16.3%). The hours of the day with the highest frequencies of admissions were between 18:00 and 24:00 (n=309; 37.72%). Drug intoxication (47.13%) was found to be the most frequently encountered reason for the admission of the cases. While 69.47% (n=569) of the cases were treated as outpatients, 29.42% (n=241) were treated as inpatients, and the mortality rate in the sample was 0.6%.
Conclusion: Most causes of pediatric forensic events are preventable. Therefore, a safe environment should be provided by taking effective protective measures, and strategies that include education in which families and children will actively participate should be developed.

Keywords

• Child
• intoxication
• emergency
• forensic event

References

1. Sever M, Saz EU, Koşargelir M. An evaluation of the pediatric medico-legal admissions to a tertiary hospital emergency department. Turk J Trauma Emerg Surg 2010; 16: 260-7.
2. Murphy SL, Xu J, Kochanek KD. Deaths: final data for 2010. Natl Vital Stat Rep 2013; 61: 1-117.
3. Türkiye İstatistik Kurumu Haber Bülteni İstatistiklerle Çocuk 2020.
4. Çinar O, Acar YA, Çevik E, et al. Acil servise başvuran 0-18 yaş grubu adli olguların özellikleri. Anatolian J Clin Invest 2010; 4: 2.
5. Büken E, Yaşar ZF. Başkent Üniversitesi Ankara Hastanesi acil servisine başvuran adli nitelikteki çocuk olguların değerlendirilmesi. Bulletin Legal Med 2015; 20.2: 93-8.
6. Korkmaz T, Erkol Z, Kahramansoy N. Evaluation of pediatric forensic cases in emergency department: A retrospective study [Acil servise gelen pediatrik adli olguların değerlendirilmesi: Retrospektif bir çalışma]. Haseki Tip Bulteni 2014; 52. 4: 271-7.
7. Yazar A, Akın F, Türe E, Odabaş D. Çocuk acil kliniğine başvuran adli vakaların değerlendirilmesi. Dicle Tıp Derg 2017; 44. 4: 345-53.
8. Gündüz RC, Halil H, Açıkalın CD, et al. Çocuk acil servisine başvuran adli olguların değerlendirilmesi. Türkiye Çocuk Hastalıkları Derg 2016; 104: 237-40.

9. Esen FH, Doğan M. Çocuk acil kliniğine başvuran adli olgular: Tek merkez deneyimi. J Pediatr Emerg Intensive Care Med 2022; 9: 7-10.
10. Sevil Ş, Yorulmaz A. Investıgatıon of the forensic cases who had been admıtted to pediatric emergency department, Selcuk Unıversıty Medıcal Faculty Hospıtal. Genel Tıp Derg 32. 2: 60-9.
11. Streatfield PK, Khan WA, Bhuiya A, et al. Mortality from external causes in Africa and Asia: evidence from INDEPTH Health and Demographic Surveillance System Sites. Glob Health Action 2014; 7: 25366.
12. Şenses O, Tursun S, Alpcan A. Analysis of poisoning cases admitted to the pediatric emergency department: 5 years of clinical experience. Kırıkkale Üniversitesi Tıp Fakültesi Derg 2021; 23. 3: 599-606.
13. Özdemir A, Elgörmüş Y, Çağ Y. Evaluation of the pediatric forensic cases admitted to emergency department. Int J Basic Clin Med 2016; 4: 1-8.
14. Aygin D, Açıl H. The study of the intoxiation cases of the patients (0-18 years) admitting to pediatric emergency unit. Med Bulletin Sisli Etfal Hospital 2014;48(1):27-33.
15. Bükülmez A, Tahta E, Şen A, Alpay F. Evaluation of patients with intoxication admitted to the pediatric emergency service. Kocatepe Med J 2013; 14. 1: 11-6.
16. Özsoylu S, Kondolot M, Akyıldız B, Özmen S, Demirci E. Evaluation of children and adolescents admitted to intensive care due to suicide attempts. Bakirkoy Tip Derg 2019; 15. 2: 131.
17. Toklucu M, Akova S, Aydoğdu S, Yazar A, Kul M. Demographic features of suicide attempt cases applied to Umraniye Education and Research Hospital pediatric emergency department between 2010 and 2012. JOPP Derg 2012; 4: 119-23.
18. Demir ÖF, Aydin K, Turan F, Yurtseven A, Erbil B, Gülalp B. Acil servise başvuran çocuk adli olguların analizi. Türk Pediatri Arşivi 2013; 48. 3: 235-40.
19. Kurtoğlu G, Karayalı O, Temrel T. 112 ile acil servise getirilen vakaların değerlendirilmesi. Turk Med J 2012; 6. 3: 73-6.
20. Akça H, Oğlakçıoğlu A, Güneri K. Evaluation of forensic cases admitted to pediatric emergency department: A single-center experience. Cerrahpasa J 2019; 43. 3: 75-9.
21. Araz C, Toklucu MÖ, Güven Ş, Pala E, Okur T. Retrospective analysis of childhood poisoning in Ümraniye. Haydarpaşa Numune Med J 2016; 56. 3: 147-60.
22. Arroyo A, Rodrigo C, Marrón MT. Evaluación toxicológica del menor. Medicina Clínica 2014; 142: 43-6.
23. Binay Ç, Şahin GT, Biçer S, et al. Çocuk acil ünitesi 2006 yılı zehirlenme vakalarının eğerlendirilmesi. J Acad Emerg Med/Akademik Acil Tip Olgu Sunumlari Derg 2010; 9: 1.