Evaluation of Accident Types and Trauma Scores in Pediatric Patients Admitted with Traffic Accident

Öz

The most common cause of trauma in the pediatric emergency department is traffic accidents. In this study, we aimed to evaluate the type of traffic accident and anatomical trauma scores in pediatric trauma patients admitted with traffic accidents. This study was performed retrospectively by examining hospital automation system, forensic records and patient files of the pediatric. 443 patients with complete records were included in the study. Of the patients included in the study, %64.1 were male, 35.2% were female and the mean age was 8.9. According to the traffic accident types patients involved in 60.5% NVTA, 32.3% RTA and 7.2% were motorcycle accidents. The mean AIS score was 1.91±1.28, and the ISS score was 3.32±3.76. No statistically significant difference was found between trauma scores AIS and ISS with regards to Traffic Accident Type. When the AIS and ISS trauma scores were evaluated by ROC analysis in terms of hospitalization and discharge, the AIS score was above cut-off point 4, and ISS score having cut-off point above 7 are the cut off points evaluated with regards to hospitalization. As a result, AIS and ISS scores; According to the degree of trauma centers, we think there are points that can be used in order not to waste time in transfer planning.

Anahtar Kelimeler

• Trauma Scores,Traffic Accident,Pediatric Patient

Trafik Kazası ile Gelen Pediatrik Hastalarda, Kaza Oluş Şekilleri ile Travma Skorlarının Değerlendirilmesi

Öz

Çocuk acil servisinde travmanın en yaygın nedeni trafik kazalarıdır. Bu çalışmada trafik kazası geçiren çocuk travma hastalarında trafik kazası tipini ve anatomik travma skorlarını değerlendirmeyi amaçladık. Bu çalışma hastane otomasyon sistemi, adli kayıtlar ve pediatrik hasta dosyaları incelenerek retrospektif olarak yapıldı. Tam kayıtları olan 443 hasta çalışmaya dahil edildi. Çalışmaya alınan hastaların% 64.1'i erkek,% 35.2'si kadın ve ortalama yaş 8.9 idi. Trafik kazası türlerine göre% 60.5 Araç dışı trafik kazası, % 32.3 Araç içi trafik kazası ve% 7.2 hasta motosiklet kazalarıydı. AIS skorunun ortalaması 1.91± 1.28, ISS skorunun ortalaması 3.32±3.76 idi. Trafik Kazası Tipine göre AIS ve ISS travma skorları arasında istatistiksel olarak anlamlı bir fark bulunmadı. AIS ve ISS travma skorları hastaneye yatış ve taburculuk açısından ROC analizi ile değerlendirildiğinde, AIS skoru kesme noktasının 4 üzerindeydi ve kesme noktası 7'nin üzerinde olan ISS skoru hastaneye yatış açısından değerlendirilen kesme noktalarıdır. Sonuç olarak AIS ve ISS skorları; Travma merkezlerinin derecesine göre, transfer planlamasında zaman kaybetmemek için kullanılabilecek puanlar olduğunu düşünüyoruz.

Anahtar Kelimeler

• Travma skorları,Trafik kazası,Pediatrik hasta

Kaynakça

1. 1. Polat O. Adli travmatolojide trafik kazalarına bakış. Adli Tıp Bülteni; 1996;1:18-25.
2. 2. TUIK.(2018).Number of accidents, persons killed and injured by year, http://www.tuik.gov.tr/ (Access date: 26.03.2018).
3. 3.Kidder K, Stein J, Frase J. The health of Canada’s children. A CICH profile 3rd ed. Ottawa (Ontario): Canadian Inst of Child Health, 2000:81-102.
4. 4. DiGuiseppi C, Roberts IG. Individual-level injury prevention strategies in the clinical setting. Future Child 2000; 10:53-82.
5. 5. Brook U, Boaz M. Children hospitalized for accidental injuries: Israeli experiences. Patient Education and Counseling 2003; 51: 177-82.
6. 6. Pitone ML, Attia MW. Patterns of injury associated with routine childhood falls. Pediatr Emerg Care 2006;22:470-4.
7. 7. Akay MA, Gürbüz N, Yayla D, Levent Elemen L, Yıldız Ekingen GY, Esen H, Yıldız T, İlçe Z. Acil servise başvuran pediatrik travma olgularının değerlendirilmesi. Kocaeli Tıp Dergisi 2013; 3: 1-5.
8. 8. Şengül AT, Kutlu T, Büyükkarabacak YB, Yetim TD, Bekdemir OS, Cemgil Öztürk C, Başoğlu A.Effects of trauma scores on prognosis in chest traumas. Türk Göğüs Kalp Damar Cerrahisi Dergisi 2012;20(4):805-811.

9. 9. MacKenzie EJ. Injury severity scales: overview and directions for future research. Am J Emerg Med 1984;2:537–48.
10. 10. Husum H, Strada G. Injury Severity Score versus New Injury Severity Score for penetrating injuries. Prehosp Disaster Med 2002;17:27-32.
11. 11. Champion HR, Copes WS, Sacco WJ, Lawnick MM, Keast SL, Bain LW Jr, et al. The Major Trauma Outcome Study: establishing national norms for trauma care. J Trauma 1990;30:1356-65.
12. 12. Chan B, Guadry P, Gratton-Smıth TM, McNeil R. The Use of Glasgow Coma Scale in Poisoning. J Emerg Med, 1993; 11: 579-82.
13. 13. Lefering R. Trauma score systems for quality assessment.Eur J Trauma 2002;28:52-63.
14. 14. Kalaycıoglu N, Kaplan ME, Unsel M. Prognostic Factors and Scoring Systems in ICU. YoğunBakımDergisi 2006;6(3):147-159.
15. 15. Stevenson,M Segui-Gomez M, Lescohier I, Scala CD, McDonald-Smith G.An overview of the injury severity score and the new injury severity score Injury Prevention .2001;7:10–13
16. 16. Sala D, Fernandez E, Morant A, Gasco J, Barrios C. Epidemiologic aspects of pediatric multiple trauma in a Spanish urban population. J Pediatr Surg. 2000;35:1478-81.
17. 17. Pant, P. R., Towner, E., Pilkington, P., Ellis, M., & Manandhar, D. Community perceptions of unintentional child injuries in Makwanpur district of Nepal: A qualitative study. BMC Public Health.2014:14(1), 476.
18. 18. Mutto, M., Lawoko, S., Nansamba, C., Ovuga, E., & Svanstrom, L. Unintentional childhood injury patterns, odds, and outcomes in Kampala City: An analysis of surveillance data from the National Pediatric Emergency Unit. J Inj Violence Res.2011: 3(1); 13-18.
19. 19. Zia, N., Khan, U. R., Razzak, J. A., Puvanachandra, P., & Hyder, A. A. Understanding unintentional childhood home injuries: Pilot surveillance data from Karachi, Pakistan. BMC Res Notes.2012: 5; 37.
20. 20. Isaac, K. N., Van Niekerk, A., & Van As, A. B. Child road traffic crash injuries at the Red Cross War Memorial Children's Hospital in Cape Town, South Africa in 1992, 2002 and 2012. Int J Inj Contr Saf Promot. 2014:1-7.
21. 21. Esteban E, Bujaldon E,Mıreıa Esparza, Jordan I, Esteban ME.Sex differences in children with severe health conditions: Causes of admission and mortality in a Pediatric Intensive Care Unit. American Journal of Human Biology.2015;27:613-9.
22. 22. Yazıcı S, Can M.Disability Due to Traffic Accidents in Children and Affecting Factors. Adli Tıp Bülteni, 2019; 24(1): 51-56.
23. 23. Jalalvandi F, Arasteh P, Faramani RS, Esmaeilivand M.Epidemiology of Pediatric Trauma and Its Patterns in Western Iran: A Hospital Based Experience. Global Journal of Health Science; 2016: 8( 6); 139-146.
24. 24. Sozuer E.M, İkizceli İ,Avşaroglu L, Yurumez Y,Yavuz Y,Yücel M.Trauma Characteristics of Primary-school-age Children in the Emergency Department.2004;4(2):59-63.
25. 25. Aoki M, Abe T, Saitoh D , Oshima K. Epidemiology, Patterns of treatment, and Mortality of Pediatric Trauma Patients in Japan. Scıentıfıc Reports. 2019 9:917;1-7.
26. 26. Karayolu Trafik Kaza İstatistikleri, 2013. Emniyet Genel Müdürlüğü ve Türkiye İstatistik Kurumu, Türkiye İstatistik Kurumu Matbaası, Ankara, 2014.
27. 27. Embleton DB,Ertoran I,Onen N,Ozkan A,Mersin H,Tekeli MC. Mortality And Morbidity in Children As Traffic Accident Victims. Kocatepe Medical Journal 2016; 17:84-88.
28. 28. Wareham K., Johansen A., Stone M. D., Saunders J.,Jones S., Lyons R. A. Seasonal variation in the incidence of wrist and forearm fractures, and its consequences. Injury. 2003;34:219–22.
29. 29. Tarğal AS , Haberal B, Hakan Şeşen H, Demirkale I,Ateş A, Altay M The Etiology And Epidemiology Of Fractures In Children Presenting To The Emergency Room In One Year: Study With 1878 Patients. Akademik Araştırma Tıp Dergisi . 2017; 2(2): 44-48.
30. 30. Potoka DA, Schall LC, Ford HR. Development of a novel age-specific pediatric trauma score. J Pediatr Surg.2001; 31: 106-12.
31. 31. Allen CJ, Wagenaar AE,Horkan DB,Baldor DJ, Hannay WM,Tashiro J, Namias N, Sola EJ. Predictors of mortality in pediatric trauma: experiences of a level 1 trauma center and an assessment of the International Classification Injury Severity Score (ICISS). Pediatr Surg Int .2016; 32:657–663.
32. 32. Kanmaz T, Çakmak M, Barlas M, Dindar H, Mecdel Y, Özgüner İF ve ark. Pediatrik travma skorlaması. Pediatrik Cerrahi Dergisi 1995; 9: 330-2.
33. 33. Alghnam S, Towhari JA , Babtain IA , Nahdi MA , Aldebasi MH , Alyami M, Alkhalaf H. The associations between injury mechanism and extended hospital stay among pediatric patients: findings from a trauma Center in Saudi Arabia. BMC Pediatrics .2019; 19(177):2-8.