Paediatric trauma aetiology, severity and outcome

Background: Paediatric injuries are a major cause of mortality and disability worldwide and account for a significant burden on countries like India with limited resources. There are very few studies from developing nations describing the outcome of paediatric trauma.

Methodology: This retrospective study was done to assess the pattern and outcome of unintentional paediatric trauma in the paediatric population. The patients were categorised into four age groups of <1 year, 1-5 years, 6-10 years and 11-15 years. The data were compared regarding the mode of trauma, new injury severity score (NISS), type of injury and place of injury among different age groups.

Results: A total of 1587 paediatric patients below 15 years of age presenting in the Emergency Department of CMC, Vellore were studied over a period of 1 year. Two-thirds were boys (1039: 66.6%). Fall on level ground (28.2%) and road traffic accidents (RTA) (26.5%) were the two most common modes of injury. A gradual change in the place of incident from home to the road with advancing age was noticed. The upper limb (30.8%) and the face (26.2%) were the most common parts of the body to be injured. One-third (35.8%) of the sustained serious injuries was a fracture or a dislocation. RTA (OR: 1.56; 95%CI: 1.08-2.26) and age ≥5 years (OR: 1.17; 95%CI: 1.08-1.26) were found to be independent predictors of severe injury (NISS >8). Only 15% required hospital admission.

Conclusion: Fall on level ground and RTAs are the most common modes of injury in the paediatric population. The place of injury shows a gradual change from the confines of home to the open dangerous roads and playgrounds with increasing age with RTA and age ≥5 years being independent predictors of severe injury.