A 15 year cohort review of in-hospital pediatric trauma center mortality: A catalyst for injury prevention programming

Govind, Shaylan; Merritt, Neil

doi:10.1016/j.amjsurg.2018.03.001

Cited by 14 publications

(14 citation statements)

References 24 publications

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“…Our study’s findings are in line with those of previous global studies that report yearly reductions in the in-hospital mortality among paediatric injured patients [ 1 , 4 , 5 , 6 ]. This study also showed that the in-hospital mortality risk in 2018 was one sixth that in 2009.…”

Section: Discussionsupporting

confidence: 92%

“…Previous studies [ 1 , 2 , 3 , 4 , 5 , 6 ] showed global differences in in-hospital mortality of paediatric injured patients, ranging from 0.12% to 8%. While the different survey methods make direct comparisons difficult, this study showed that the overall in-hospital mortality was 4.1%, not much lower than that of other developed countries [ 1 , 2 , 3 , 4 , 5 , 6 ], and that paediatric injured patients <1 year, with high TRISS Ps, and those who underwent urgent blood transfusion, had a high mortality risk, therefore, it is considered these factors will be most effective to improve injury care systems for decreasing the mortality rate of affected patients. In this study, the in-hospital mortality of those <1 year did not improve during the 10-year study period wherein no decreasing tendency was observed.…”

Section: Discussionmentioning

confidence: 99%

“…Injury, due to road traffic crash, fall, drowning, fires, or poisoning, is a major cause of child mortality worldwide [ 1 ]. Previous studies showed that in-hospital mortality of paediatric injured patients varied from 0.19% to 8% in Australia, USA, Canada, and Europe [ 2 , 3 , 4 , 5 , 6 ]. In these reports, the incidence of childhood injury and risk factors for in-hospital mortality after injury also varied by countries.…”

Section: Introductionmentioning

confidence: 99%

“…On the other hand, in Japan, the proportion of deaths related to road traffic crash decreased year by year, while the proportion of deaths related to injury events happening at home increased [ 7 , 8 ]. Furthermore, the trend of in-hospital mortality in paediatric injured patients was also reported to vary by injury mechanism and age-related injury characteristics [ 1 , 2 , 3 , 4 , 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

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Ten-Year in-Hospital Mortality Trends among Paediatric Injured Patients in Japan: A Nationwide Observational Study

Toida

Muguruma

Gakumazawa

et al. 2020

JCM

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Injury is a major cause of worldwide child mortality. This retrospective nationwide study aimed to evaluate the characteristics of paediatric injured patients in Japan and their in-hospital mortality trends from 2009 to 2018. Injured patients aged <17 years were enrolled. Data were extracted from the Japan Trauma Data Bank. In the Cochran-Armitage test, in-hospital mortality significantly decreased during the study period (p < 0.001), except among patients <1 year old, and yearly reductions were observed among those with an Injury Severity Score ≥16 and survival rate ≥50% (p < 0.001). In regression analyses, patients who underwent urgent blood transfusion within 24 h after hospital admission (odds ratio (OR) = 3.24, 95% confidence interval (CI) = 2.38–4.41) had a higher in-hospital mortality risk. Higher survival probability as per the Trauma and Injury Severity Score was associated with lower in-hospital mortality (OR = 0.92, 95% CI = 0.91–0.92), a risk which decreased from 2009 to 2018 (OR = 6.16, 95% CI = 2.94–12.88). Based on our results, there is a need for improved injury surveillance systems for establishment of injury prevention strategies along with evaluation of the quality of injury care and outcome measures.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Ten-Year in-Hospital Mortality Trends among Paediatric Injured Patients in Japan: A Nationwide Observational Study

Toida

Muguruma

Gakumazawa

et al. 2020

JCM

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“…Abusive head trauma (AHT) continues to be a major cause of traumatic deaths and long-term morbidity in infants due to child abuse 1–3. Ascribing AHT as the cause of an intracranial injury (ICI) is challenging for clinicians as the differential diagnosis may include abuse, accidental trauma or other childhood diseases 4.…”

Section: Introductionmentioning

confidence: 99%

Validation of the PredAHT-2 prediction tool for abusive head trauma

et al. 2020

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ObjectiveThe validated Predicting Abusive Head Trauma (PredAHT) clinical prediction tool calculates the probability of abusive head trauma (AHT) in children <3 years of age who have sustained intracranial injuries (ICIs) identified on neuroimaging, based on combinations of six clinical features: head/neck bruising, seizures, apnoea, rib fracture, long bone fracture and retinal haemorrhages. PredAHT version 2 enables a probability calculation when information regarding any of the six features is absent. We aimed to externally validate PredAHT-2 in an Australian/New Zealand population.MethodsThis is a secondary analysis of a prospective multicentre study of paediatric head injuries conducted between April 2011 and November 2014. We extracted data on patients with possible AHT at five tertiary paediatric centres and included all children <3 years of age admitted to hospital who had sustained ICI identified on neuroimaging. We assigned cases as positive for AHT, negative for AHT or having indeterminate outcome following multidisciplinary review. The estimated probability of AHT for each case was calculated using PredAHT-2, blinded to outcome. Tool performance measures were calculated, with 95% CIs.ResultsOf 87 ICI cases, 27 (31%) were positive for AHT; 45 (52%) were negative for AHT and 15 (17%) had indeterminate outcome. Using a probability cut-off of 50%, excluding indeterminate cases, PredAHT-2 had a sensitivity of 74% (95% CI 54% t o89%) and a specificity of 87% (95% CI 73% to 95%) for AHT. Positive predictive value was 77% (95% CI 56% to 91%), negative predictive value was 85% (95% CI 71% to 94%) and the area under the curve was 0.80 (95% CI 0.68 to 0.92).ConclusionPredAHT-2 demonstrated reasonably high point sensitivity and specificity when externally validated in an Australian/New Zealand population. Performance was similar to that in the original validation study.Trial registration numberACTRN12614000463673.

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Correlation between early computed tomography findings and neurological outcome in pediatric traumatic brain injury patients

Şahin,

Botan,

Gün

et al. 2024

Neurol Sci

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Traumatic brain injury (TBI) is a leading cause of morbidity and mortality in children. Head computed tomography (CT) is frequently utilized for evaluating trauma-related characteristics, selecting treatment options, and monitoring complications in the early stages. This study assessed the relationship between cranial CT findings and early and late neurological outcomes in pediatric TBI patients admitted to the pediatric intensive care unit (PICU). The study included children aged 1 month to 18 years who were admitted to the PICU due to TBI between 2014 and 2020. Sociodemographic data, clinical characteristics, and cranial CT findings were analyzed. Patients were categorized based on their Glasgow Coma Scale (GCS) score. Of the 129 patients, 83 (64%) were male, and 46 (36%) were female, with a mean age of 6.8 years. Falls (n = 51, 39.5%) and in-vehicle traffic accidents (n = 35, 27.1%) were the most common trauma types observed. Normal brain imaging findings were found in 62.7% of the patients, while 37.3% exhibited intracranial pathology. Hemorrhage was the most frequent CT finding. Severe TBI (n = 26, p = 0.032) and mortality (n = 9, p = 0.017) were more prevalent in traffic accidents. The overall mortality rate in the study population was 10.1%. In children with TBI, cranial CT imaging serves as an essential initial method for patients with neurological manifestations. Particularly, a GCS score of ≤ 8, multiple hemorrhages, diffuse cerebral edema, and intraventricular bleeding are associated with sequelae and mortality.

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A 15 year cohort review of in-hospital pediatric trauma center mortality: A catalyst for injury prevention programming

Cited by 14 publications

References 24 publications

Ten-Year in-Hospital Mortality Trends among Paediatric Injured Patients in Japan: A Nationwide Observational Study

Ten-Year in-Hospital Mortality Trends among Paediatric Injured Patients in Japan: A Nationwide Observational Study

Validation of the PredAHT-2 prediction tool for abusive head trauma

Correlation between early computed tomography findings and neurological outcome in pediatric traumatic brain injury patients

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