A 4-Year Review of Severe Pediatric Trauma in Eastern Ontario: A Descriptive Analysis

Osmond, Martin H.; Brennan-Barnes, Maureen; Shephard, Allyson

doi:10.1097/00005373-200201000-00004

Cited by 34 publications

(35 citation statements)

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“…Several studies have reported the head region as the most commonly affected body system. [9][10][11][12][13] The reason for the high frequency of head injury following falls in children can be explained by their higher head/body ratio compared with adults, which makes landing on their heads more likely. 7 12 Fractures of the extremities in our study had a frequency of 14.5%, which put the second place for frequency.…”

Section: Discussionmentioning

confidence: 99%

“…[3][4][5][6][7] An important role of any trauma centre is to study the frequency, distribution, cause, and pattern of its trauma population and to compare these data with other trauma centres, in order to develop strategies to prevent injuries, which are applicable regionally and locally. [8][9][10] Several trauma scoring systems have been developed to measure the severity of the injury, and to analyse its impact on morbidity and mortality for trauma research. The most common scoring systems used include the Glasgow Coma Scale (GCS), 11 Revised Trauma Score, 12 Pediatric Trauma Score (PTS), 13 Injury Severity Score (ISS), 14 and the Trauma and Injury Severity Score.…”

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confidence: 99%

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Childhood falls: characteristics, outcome, and comparison of the Injury Severity Score and New Injury Severity Score

Bulut

Köksal²,

Korkmaz³

et al. 2006

Emergency Medicine Journal

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Objectives: The aim of this study was to determine the general characteristics of childhood falls, factors affecting on mortality, and to compare the Injury Severity Score (ISS) and the New Injury Severity Score (NISS) as predictors of mortality and length of hospital stay in childhood falls. Methods: We retrospectively analysed over a period of 8 years children aged younger than14 years who had sustained falls and who were admitted to our emergency department. Data on the patients' age, sex, type of fall, height fallen, arrival type, type of injuries, scoring systems, and outcome were investigated retrospectively. The ISS and NISS were calculated for each patient. Comparisons between ISS and NISS for prediction of mortality were made by receiver operating characteristic (ROC) curve and HosmerLemeshow (HL) goodness of fit statistics. Results: In total, there were 2061 paediatric trauma patients. Falls comprised 36 (n = 749) of these admissions. There were 479 male and 270 female patients. The mean (SD) age was 5.01 (3.48) years, and height fallen was 3.8 (3) metres. Over half (56.6%) of patients were referred by other centres. The most common type of fall was from balconies (38.5%), and head trauma was the most common injury (50%). The overall mortality rate was 3.6%. The cut off value for both the ISS and NISS in predicting mortality was 22 (sensitivity 90.5%, specificity 95.4% for ISS; sensitivity 100%, specificity 88.7% for NISS) (p.0.05). Significant factors affecting mortality in logistic regression analysis were Glasgow Coma Scale (GCS) ,9, ISS .22, and NISS .22. There were no significant differences in ROC between three scoring systems. The HL statistic showed poorer calibration (p = 0.02 v p = 0.37, respectively) of the NISS compared with the ISS. Conclusions: In our series, the head was the most frequent site of injury, and the most common type of fall was from balconies. Scores on the GCS, NISS, and ISS are significantly associated with mortality. The performance of the NISS and ISS in predicting mortality in childhood falls was similar.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Childhood falls: characteristics, outcome, and comparison of the Injury Severity Score and New Injury Severity Score

Bulut

Köksal²,

Korkmaz³

et al. 2006

Emergency Medicine Journal

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“…20 A prior Canadian analysis of severe pediatric trauma in Ontario determined that sports were responsible for 5% of trauma cases admitted to hospital over a four-year period. 21 Unlike this prior study from Ontario, we examined injury severity and patient outcomes by type of activity, and we included cycling as a sport/recreational activity, since it has a corresponding CIHI Sport & Recreation Code in the NSTR. Our results agree with Canadian data from CIHI, showing that cycling injuries are the most common injury from summer sport and recreational activity, with males aged 10-14 years hospitalized most frequently.…”

Section: Discussionmentioning

confidence: 99%

A Retrospective Evaluation of Pediatric Major Trauma Related to Sport and Recreational Activities in Nova Scotia

Green

Butler

Kureshi

et al. 2015

CJEM

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Objectives: A small proportion of pediatric sport-and recreation-related injuries are serious enough to be considered "major trauma." However, the immediate and long-term consequences in cases of pediatric major trauma are significant and potentially life-threatening. The objective of this study was to describe the incidence and outcomes of pediatric major traumas related to sport and recreational activities in Nova Scotia. Methods: This study was a retrospective case series. Data on major pediatric traumas related to sport and recreational activities on a provincial scope were extracted from the Nova Scotia Trauma Program Registry between 2000 and 2013. We evaluated frequency, type, severity, and outcomes of major traumas. Outcomes assessed included length of hospital stay, admission to a special care unit (SCU), and mortality. Results: Overall, 107 children aged three to 18 years sustained a major trauma (mean age 12.5 [SD 3.8]; 84% male). Most injuries were blunt traumas (97%). The greatest proportion were from cycling (59, 53%), followed by hockey (8, 7%), skateboarding (7, 7%) and skiing (7, 7%). The Nova Scotia Pediatric Trauma Team was activated in 27% of cases. Mean in-hospital length of stay was five days (SD 5.6), and nearly half (49%) of patients required SCU admission. Severe traumatic brain injury occurred in 52% of cases, and mortality in five cases. Conclusions: Over a 13-year period, the highest incidence of pediatric major trauma related to sport and recreational activities was from cycling, followed by hockey. Severe traumatic brain injury occurred in over half of pediatric major trauma patients. RÉSUMÉObjectif: Les blessures liées au sport et aux activités récréatives chez les enfants sont, dans une faible proportion, suffisamment sérieuses pour être considérées comme des « traumas graves ». Toutefois, les conséquences immédiates et lointaines de ces traumas graves chez les enfants sont importantes et potentiellement mortelles. L'étude visait à faire état de la fréquence des traumas graves liés au sport et aux activités récréatives ainsi que des résultats cliniques chez les enfants en Nouvelle-Écosse. Méthode: L'étude consistait en une série rétrospective de cas. Les données sur les traumas graves liés au sport et aux activités récréatives chez les enfants, à l'échelle provinciale, ont été tirées du Nova Scotia Trauma Program Registry, pour la période de 2000 à 2013. Ont été évalués la fréquence des traumas graves, de même que le type, la gravité et les résultats cliniques. Les résultats évalués comprenaient la durée du séjour à l'hôpital, l'admission dans un service de soins spécialisés (SSS) et la mortalité. Résultats: Dans l'ensemble, 107 enfants, âgés de 3 à 18 ans, ont subi un trauma grave (âge moyen: 12,5 [écart type {σ}: 3,8] ans; garçons: 84 %). Dans la plupart des cas, il s'agissait de traumatisme contondant (97 %). Les accidents étaient attribuables, en ordre décroissant, au cyclisme (59; 53 %), au hockey (8; 7 %), à la planche à roulettes (7; 7 %) et au ski (7; 7 %). L'équip...

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“…This peculiarly occurs from unguarded rooftops while the child is playing. However, Osmond[4] from Canada cites motor accidents as the most common cause. The most common lesion seen on CT scan was an EDH, whereas Mahapatra reports contusion as the most common.…”

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confidence: 99%

Pediatric head injury: An epidemiological study

et al. 2011

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A 4-Year Review of Severe Pediatric Trauma in Eastern Ontario: A Descriptive Analysis

Abstract: Research efforts and activities to prevent severe pediatric trauma in our region should focus on road safety, protection from head injuries, avoidance of falls, and prevention of child abuse.

Cited by 34 publications

References 7 publications

Childhood falls: characteristics, outcome, and comparison of the Injury Severity Score and New Injury Severity Score

Childhood falls: characteristics, outcome, and comparison of the Injury Severity Score and New Injury Severity Score

A Retrospective Evaluation of Pediatric Major Trauma Related to Sport and Recreational Activities in Nova Scotia

Pediatric head injury: An epidemiological study

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