ASSESSMENT OF THE CLINICAL AND NOSOLOGICAL CHARACTERISTICS OF TRAFFIC INJURIES IN CHILDREN AS A MEDICAL AND SANITARY CONSEQUENCE OF A MAN MADE EMERGENCY SITUATION

Abstract

All over the world, children’s injuries receive considerable attention. Road traffi c injury is the main cause of child death. The aim of the research. To study and evaluate the clinical and nosological characteristics of traffi c injuries in children as a medical and sanitary consequence of an emergency situation. Research materials and methods. This work is a continuation of the previous research [2], and is based on the study and retrospective analysis of 259 cases of children injured as a result of a traffi c accident in the Kyiv and Chernivtsi regions in 2018-2019. The array of this study was formed by the method of irreversible randomization from the total array of 1,671 cases of traffi c injuries that occurred in urban and rural areas of these regions. This work was carried out within the framework of the Doctoral Thesis «Traffi c accidents (clinical- epidemiological, clinical- nosological characteristics, clinical features of the course of the traumatic process, principles of medical care)», approved by the Academic Council of the «Ukrainian Scientifi c and Practical Center of Emergency Medical Aid and Disaster Medicine» of the Ministry of Health of Ukraine (Minutes of the meeting of the Scientifi c Council No. 6, December 15, 2020), in accordance with the provisions of the Declaration of Helsinki and approved by the Bioethics Commission of the «Ukrainian Scientifi c and Practical Center of Emergency Medical Aid and Disaster Medicine» of the Ministry of Health of Ukraine (Protocol No. 10, December 8, 2020). Research results. As a result of the research it was established that in the total number of children with road traffi c injuries, the largest specifi c weight have children with the extent of damage to two anatomical and functional areas (AFA) – 47.67 %, and the smallest specifi c weight – four AFA (13.95 %). In 84.88 % of traffi c injuries in children, they are polysystemic, i. e. two or more AFA are damaged, in the mass of the dead, the specifi c weight of such an injury is 90.91 %. The highest mortality rate was observed in children with damage to three AFAs (15.00 %), with damage to one AFA the mortality rate was 7.69 %, with damage to two AFAs – 14.63 %, with damage to four AFAs – 8.33 %. In the total number of injured children, the most frequent injury is to the head (82.56 %), and the least frequent is damage to the abdomen and pelvis with a specifi c gravity of 13.95 %. Limb injuries (56.98 %), chest injuries (41.86 %) and spine injuries (16.28 %) are also quite common in children. The combination factor in the general fi eld is 2.26, in the fi eld of the dead – 2.46 and in the fi eld of the survivors – 2.23. The highest mortality is observed in victims with abdominal and pelvic trauma (25.0 % each), which is almost twice as high as the mortality in the general population (12.79 %). In second place is the mortality rate of children with chest trauma – 19.44 %, with head trauma – 16.90 %, with spinal trauma – 7.14 %. The lowest mortality rate was recorded for children with limb injuries – 4.08 %. Conclusions. 1. Traffi c injuries in children in 84.88 % of cases are multicomponent, the combination ratio in the total mass is 2.26. 2. Head (82.56 %), limbs (56.98 %) and chest (41.86 %) are most often injured in traffi c accidents. 3. The highest mortality rate is observed in children with pelvic and abdominal trauma (25.0 % each).

Keywords

• Traffi c Injury; Children; Clinical and Epidemiological Characteristics; Emergency Situation