Paediatric Blunt Torso Trauma: Injury mechanisms, patterns and outcomes among children requiring hospitalisation at the Sultan Qaboos University Hospital, Oman

Bhatti, Khalid M.; Taqi, Kadhim M.; Al-Harthy, Ahmed; Hamid, Rana Shoaib; Al-Balushi, Zainab; Sankhla, Dilip; Al-Qadhi, Hani

doi:10.18295/squmj.2016.16.02.012

Cited by 7 publications

(8 citation statements)

References 18 publications

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“…Differences in playtime behaviour between genders may be one reason for such findings, as well as higher activity levels, greater freedom to play alone, and increased involvement in risky sports among males. In this study, children in the younger age groups were the most commonly involved, with the mean age being six years, a finding similar to the study done by Bhatti et al in Oman in 2016, another developing country [15] . Most of the injuries occurred in private homes, accounting for 42.4%, with an additional 25.7% happening in other residential buildings such as apartment complexes.…”

Section: Discussionsupporting

confidence: 90%

Patterns and outcomes of paediatric trauma at a tertiary teaching hospital in Kenya

Ndung'u

Sun

Musau

et al. 2019

African Journal of Emergency Medicine

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Introduction Trauma continues to be a major cause of morbidity and mortality especially in the paediatric population of low- and middle-income countries such as Kenya. The aim of this study was to establish the profile and outcomes of admitted paediatric trauma cases at the Aga Khan University Hospital, Nairobi. Methods This retrospective, descriptive study involved a 12-month chart review (January 2016–December 2016). A total of 218 records were identified of which 144 were reviewed. Results Most injuries were amongst boys (65.3%) and the very young (mean age 6), occurred in private residences (42.4% homes, 25.7% residential institutions), were typically caused by falls (56.3%) or penetrating trauma (13.2%), mostly resulted in extremity fractures (45.8% closed, 4.9% open) and burn or head injuries (in infants and small children), and got very little or no pre-hospital care (51.4% no care). Additionally, children with burns, brain injuries, or poly-trauma had the longest hospital stays and highest rates of mortality. A more detailed description of the patterns and outcomes seen are included in the study. Discussion Paediatric injuries remain a major public health problem and contribute a substantial proportion of all paediatric surgical admissions at the Aga Khan University Hospital in Nairobi. Based on the patterns and outcomes seen in this study, we therefore recommend for Nairobi (and possibly Kenya) to establish greater supervision and safety measures for children; targeting safety interventions at all children but particularly at boys, the very young, at home and in residential buildings; building pre-hospital emergency care that can accommodate children; and equipping paediatric trauma hospitals to especially handle bony fractures, burns, head injuries, and poly-traumas. A bespoke trauma registry would benefit the hospital, and likely the country as a whole.

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Section: Discussionsupporting

confidence: 90%

Patterns and outcomes of paediatric trauma at a tertiary teaching hospital in Kenya

Ndung'u

Sun

Musau

et al. 2019

African Journal of Emergency Medicine

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“…The American Surgeon™ 89 (12) 7 g/dL and persistent tachycardia for more than 24 hours. Patient vital signs were recorded at 12-hour intervals during their hospital stay and were used to assess hemodynamic stability.…”

Section: Resultsmentioning

confidence: 99%

“…The 2000 APSA guidelines for treatment of solid organ injuries in pediatric patients ushered in a wealth of studies aiming to define how best to manage, safely discharge, and follow these patients. [4][5][6][7]12 The original guidelines were based on national registry data of 832 patients over a 2-year period among 32 pediatric surgical centers. The study analyzed ICU stay, LOS, transfusion requirement, need for operative intervention, need for repeat imaging, and restriction of physical activity.…”

Section: Discussionmentioning

confidence: 99%

Validation for Abbreviated Hospital Stay in Pediatric Patients with Solid Organ Injury

Griffin

Richardson

Brierley

et al. 2023

The American Surgeon™

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Background In 2000, the American Pediatric Surgical Association (APSA) published guidelines for the management of pediatric solid organ injury, recommending a hospital length of stay (LOS) of grade of injury plus 1 day. Since the publication of these guidelines, several studies have suggested that it is safe to discharge patients sooner based upon hemodynamic and clinical factors. The results of several of these studies have been confounded by the existence of other injuries. The aim of this study was to examine LOS and outcomes in children with strictly isolated solid organ injuries. Materials and Methods This is a 12-year retrospective review of pediatric patients with isolated trauma to the kidney, liver, or spleen to determine LOS. Patients were excluded for associated intracranial, neurologic, orthopedic, or pulmonary injuries which would impact length of stay. Documented hemodynamic parameters were reviewed as determinants of patient stability. Results A total of 156 patients were included in the study. The projected average LOS for all patients based on the 2000 APSA guidelines would have been 3.71 ± 0.98 days. The actual average LOS for all patients 2.85 ± 3.32 days. Need for operation, ICU stay, and transfusion all contributed to increased LOS. The number of episodes of abnormal vitals positively correlated with increased LOS. Discussion This study validates that management of isolated solid organ injuries based upon hemodynamic parameters and clinical status is safe and decreases hospital length of stay. Consistently normal vital signs indicate these children can be safely discharged sooner.

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“…Unintentional injury was found to be a leading cause of child death and disability in Hong Kong. Among children (age 1-4) and youth (age [5][6][7][8][9][10][11][12][13][14], injury and poisoning led to 3.1 deaths per 100,000 and 3.7 deaths per 100,000 respectively. From the Child and Health Survey conducted in 2005 to 2006 in Hong Kong, the prevalence of injury that needed medical advice or treatment in children aged 14 and below was 4.4%.…”

Section: Introductionmentioning

confidence: 99%

“…8,9 On the other hand, economic deprivation should also be considered as western study has identified a higher injury rate in preadolescent children and in the school playground for the low-income group 10 and more children from deprived areas attended with head injured. 11 Given trauma as the greatest reason of morbidity and mortality in paediatric populations worldwide 12 and a recent literature search has identified only six relevant papers identified for Hong Kong with the latest studies being done in 2003, 6 attention should be paid to paediatric trauma population. There was certainly a need of conducting a study on the spectrum of paediatric trauma in Hong Kong, and to address knowledge gaps in epidemiology and prevention.…”

Section: Introductionmentioning

confidence: 99%

Epidemiology of paediatric trauma in Hong Kong: A multicentre cohort study

Chow

Leung²,

Leung

et al. 2019

Clinical Epidemiology and Global Health

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Introduction: Trauma is the commonest cause of death and major morbidities in children and adolescents worldwide. There has been a lack of data on the epidemiology of trauma among children in Chinese cities include Hong Kong. Therefore the current study was conducted to examine the spectrum of paediatric trauma in Hong Kong and to address knowledge gaps in its epidemiology and prevention. Objective: This study aimed to describe the epidemiological features of paediatric trauma and explore the characteristics in the low income group which would help to guide the design of effective interventions and future research on prevention of paediatric trauma. Method: A descriptive study on the epidemiology of trauma in children ≤18-year-old using a standardised injury registry embedded within a population-based hospital database. Information on demographics, injury type, mechanism, injury severity score (ISS) and injury prevention prioritization score (IPPZ) were collected to identify the epidemiological features and prevention initiatives. Result: The overall female to male ratio was 1: 1.97, which increased with age from 1:1.45 (infant; below 2 years old) to 1:2.67 (adolescent; 12-18 years old). The overall mean ISS was 7.98 (SD 9.18), ISS increased with age significantly (rho = 0.143, P < 0.001). The most common context of trauma included travelling (IPPZ: 59.94, mean ISS 10.2 ± 10.23, n = 402), leisure activities (IPPZ: 52.04, mean ISS 5.6 ± 6.77, n = 312), street/ highway (IPPZ: 70.22, mean ISS 10.48 ± 10.53, n = 475) and home (including garden and out buildings) (IPPZ: 69.56, mean ISS 6.64 ± 7.94, n = 539). Severity of paediatric injuries among low-income group did not differ from the general population. Conclusion: The study provided updated epidemiological characteristics of paediatric trauma, which could be used to guide focus prevention of paediatric trauma. The findings also highlighted further study initiatives including injury surveillance, geographical analysis and environment modification.

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Paediatric Blunt Torso Trauma: Injury mechanisms, patterns and outcomes among children requiring hospitalisation at the Sultan Qaboos University Hospital, Oman

Cited by 7 publications

References 18 publications

Patterns and outcomes of paediatric trauma at a tertiary teaching hospital in Kenya

Patterns and outcomes of paediatric trauma at a tertiary teaching hospital in Kenya

Validation for Abbreviated Hospital Stay in Pediatric Patients with Solid Organ Injury

Epidemiology of paediatric trauma in Hong Kong: A multicentre cohort study

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