Epidemiological Analysis of Paediatric Trauma in Intensive Care: A 10-Year Retrospective Study from 2009 to 2018

Abstract

Background Paediatric trauma is a pivotal factor contributing to paediatric mortality, with traffic injuries and falls being commonly reported as leading causes of significant injuries among children. Comprehensive investigations from multiple perspectives, including geographical considerations, are crucial to develop more effective strategies for preventing such injuries and thereby reducing the burden of paediatric trauma. Methods This study involved a retrospective analysis of clinical data from paediatric patients admitted to our hospital's intensive care unit (ICU) due to trauma over a 10-year period. Comprehensive analyses were conducted to elucidate trends, demographics, injury patterns, and risk factors associated with these admissions. Results This retrospective study included 951 paediatric patients (mean age: 4.79 ± 3.24 years; mean weight: 18.45 ± 9.02 kg; median time to ICU admission post-injury: 10.86 ± 14.95 hours). Of these patients, 422 (44.4%) underwent emergency surgery and 466 (49%) required mechanical ventilation support, with a mean duration of 70.19 ± 146.62 hours. The mean duration of ICU stay was 6.24 ± 8.01 days and overall mean hospital stay was 16.08 ± 15.56 days. The predominant cause of unintentional injury was traffic accidents (47.9%), followed by falls (42.5%) and burns/scalds (5.3%). Most incidents involved children aged 0–6 years (70.7%), with males comprising 60.0% of cases. Injury incidents predominantly occurred between 12 PM and 6 PM (44.5%) and on non-workdays (37.6%). The most common sites of injury were roadsides (49.0%) and rural areas (64.35%). Single-site injuries (58.78%) were more prevalent than multiple-site injuries (41.22%), and head injuries were the most common among single-site injuries (81.57%). At ICU admission, the mean injury severity score was 18.49 ± 8.86. Following active intervention, 871 patients (91.59%) showed improvement, whereas 80 (8.41%) succumbed to their injuries. Conclusion Traffic injuries remain the primary cause of paediatric trauma, underscoring the ongoing importance of appropriate use of child restraint systems and protective gear as fundamental preventive measures. The elevated incidence of injuries among children under 6 years old and those residing in rural areas highlights the need for targeted preventive strategies, necessitating tailored interventions and public policy formulations that specifically address these high-risk populations.