Assessment of Pediatric Trauma Patients in a Tertiary Care Hospital and Identification of Predictive Factors of Trauma Severity

Abstract

INTRODUCTION: The aim of our study is to present the characteristics of the trauma patients in our tertiary hospital, to identify the risk factors that raise Injury Severity Score (ISS) and to contribute to our national data. METHODS: All pediatric trauma patients admitted to our clinic between September 2007-December 2017 were retrospectively reviewed. Age, trauma type, trauma mechanism, transport status, fracture, transfusion requirement, number of consultations, hospital stay, intensive care stay, need for mechanical ventilation and operation were investigated. Patients were assessed in two groups: ISS>11 (severe injury) and ISS≤11 (minor injury). RESULTS: Median age was 8 [4-12] in a total of 799 patients. The most injury mechanisms was fall from hights. Most of the injuries (83.5%) were blunt. Most of the patients (87.6%) were admitted directly to our hospital. Bone fractures were detected in 75 patients (9.4%). The mean age of patients with ISS>11 was found higher (p<0.05). Patients aged 7-12 years, transferred patients, patients with multiple affected body parts have a higher risk of severe injury (p<0.05). The trauma mechanism did not affect the severity of the trauma. In univariate analysis, male sex, transferred patients, blunt trauma, or accompanied fracture have increased the likelihood that the patient has a severe trauma. DISCUSSION AND CONCLUSION: The determination of a severe trauma risk, ie a high ISS, allows for quicker and more accurate decision-making in the management of trauma patients. In addition to ISS, there are also independent factors that indicate the severity of the trauma. These admitted patients should be considered as high risk patients.

Keywords

• pediatric trauma
• injury severity score
• severe trauma