Trends in trauma-related mortality among adolescents: A 6 year snapshot from a teaching hospital's post mortem data

Kumar, Sachil

doi:10.1016/j.jcot.2017.02.006

Cited by 5 publications

(2 citation statements)

References 36 publications

(46 reference statements)

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“…Unintentional deaths from selfies have received limited exposure in emergency medicine literature; 2 yet trauma remains the leading cause of death and disability in children and young adults. 3 Although selfie-related injuries are a relatively new phenomenongenerally perceived as a harmless, frivolous faddata suggest they are a public health hazard that may only increase with the simultaneous prevalence and ubiquity of smartphones and social media use in most peoples' daily lives. 2 The impact of selfie-related incidents should not be underestimated by emergency medicine and retrieval specialists.…”

Section: Opinionmentioning

confidence: 99%

Preventing selfie‐related incidents: Taking a public health approach to reduce unnecessary burden on emergency medicine services

Cornell

Brander

Peden

2023

Emerg Medicine Australasia

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Unintentional deaths from selfies have received limited exposure in emergency medicine literature; yet trauma remains the leading cause of death and disability in children and young adults, and most of those implicated in a selfie incident are in this demographic. Selfie-related injuries and deaths may be a relatively new phenomenon, but data suggest they are a public health hazard that is not going away. Emergency medicine practitioners may have a role to play in the primary and secondary prevention of selfie incidents, including delivering opportunistic behaviour change messaging to those who are at risk of being injured or killed in a selfierelated incident, particularly young (14-25 years) males. Emergency medicine specialists should be aware of the dangers of selfie-related incidents and understand their polytraumatic presentation.

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Section: Opinionmentioning

confidence: 99%

Preventing selfie‐related incidents: Taking a public health approach to reduce unnecessary burden on emergency medicine services

Cornell

Brander

Peden

2023

Emerg Medicine Australasia

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“…Trauma is mostly caused by sudden injuries or accidents resulting in tissue injury [ 1 ]. It is a frequently overlooked primary cause contributing to mortality and disability in children and adolescents globally [ 2 – 4 ]. In the United States, injury-related causes accounted for > 60% of deaths among children and adolescents in 2016 [ 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

Shock index and shock index, pediatric age-adjusted as predictors of mortality in pediatric patients with trauma: A systematic review and meta-analysis

Yoon,

Shin,

Kim

et al. 2024

PLoS ONE

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This study aimed to assess the predictive ability of the shock index (SI) and the shock index, pediatric age-adjusted (SIPA) for mortality among pediatric patients with trauma (aged ≤ 18 years). A systematic search used PubMed, Embase, and Cochrane Library databases to identify pertinent articles published from their inception to 13 February 2023. For each SI and SIPA, the pooled sensitivity, specificity, diagnostic odds ratio (DOR), and area under the summary receiver operating characteristic curve (AUC) with the corresponding 95% confidence intervals were calculated. We planned a priori meta-regression analyses to explore heterogeneity using the following covariates: country, clinical setting, type of center, data source, and cutoff value. Twelve studies were included based on the inclusion criteria. Among them, nine studies with 195,469 patients were included for the SIPA at the hospital, four studies with 4,970 patients were included for the pre-hospital SIPA, and seven studies with 606,445 patients were included to assess the ability of the SI in predicting mortality. The pooled sensitivity and specificity with 95% confidence interval for predicting mortality were as follows: 0.58 (0.44–0.70) and 0.72 (0.60–0.82), respectively, for the SIPA at the hospital; 0.61 (0.47–0.74) and 0.67 (0.61–0.73), respectively, for the pre-hospital SIPA; and 0.71 (0.59–0.81) and 0.45 (0.31–0.59), respectively for the SI. The DOR were 3.80, 3.28, and 2.06 for the SIPA at the hospital, pre-hospital SIPA, and SI, respectively. The AUC were 0.693, 0.689, and 0.618 for the SIPA at the hospital, pre-hospital SIPA, and SI, respectively. The SI and SIPA are simple predictive tools with sufficient accuracy that can be readily applied to pediatric patients with trauma, but SIPA and SI should be utilized cautiously due to their limited sensitivity and specificity, respectively.

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Quality of pediatric trauma care: development of an age-adjusted TRISS model and survival benchmarking in a major trauma center

De los Ríos-Pérez,

García,

Gomez

et al. 2024

Front. Pediatr.

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BackgroundPediatric trauma is a major global health concern, accounting for a substantial proportion of deaths and disease burden from age 5 onwards. Effective triage and management are essential in pediatric trauma care, and prediction models such as the Trauma Injury Severity Score (TRISS) play a crucial role in estimating survival probability and guiding quality improvement. However, TRISS does not account for age-specific factors in pediatric populations, limiting its applicability to younger patients. This study aimed to modify TRISS to account for age for children (Peds-TRISS) and to evaluate its performance relative to the original TRISS. We also assessed survival outcomes to explore the model's potential utility across various clinical settings. These efforts align with quality improvement initiatives to reduce preventable mortality and supporting sustainable development goals.MethodsThis retrospective cohort study included patients under 18 years of age who were treated at a hospital in Colombia between 2011 and 2019. New coefficients for TRISS covariates were calculated using logistic regression, with age treated as a continuous variable. Model performance was evaluated based on discrimination (C statistic) and calibration, comparing Peds-TRISS with the original TRISS. Internal validation was conducted using bootstrap resampling. Survival outcomes were assessed using the M and Z statistics, which are commonly used for international trauma outcome comparisons.ResultsThe study included 1,013 pediatric patients with a median age of 12 years (IQR 5–15), of whom 73% were male. The leading causes of injury were traffic accidents (31.1%), falls (28.8%), and assaults (28.7%). The overall mortality rate was 5.7%. The Peds-TRISS model demonstrated good calibration (HL = 9.7, p = 0.3) and discrimination (C statistic = 0.98, 95% CI 0.97–0.99), with no statistically significant difference in the ROC curve comparison with the original TRISS. Internal validation demonstrated strong performance of Peds-TRISS. The M and Z statistics were 0.93 and 0, respectively, indicating no significant differences between expected and observed survival rates.ConclusionsMost fatalities occurred among adolescents and were due to intentional injuries. The Peds-TRISS model showed a partial improvement in performance compared to the original TRISS, with superior results in terms of calibration, although not in discrimination. These findings highlight the potential of model customization for specific populations. Prospective, multicenter studies are recommended to further validate the model's utility across diverse settings.

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Trends in trauma-related mortality among adolescents: A 6 year snapshot from a teaching hospital's post mortem data

Abstract: Findings show that there was a predominance of deaths in children and adolescents males, between 15 and 18 years old, mainly from road traffic accidents. This study highlights the burden of trauma caused mortalities in children, which requires instant action.

Cited by 5 publications

References 36 publications

Preventing selfie‐related incidents: Taking a public health approach to reduce unnecessary burden on emergency medicine services

Preventing selfie‐related incidents: Taking a public health approach to reduce unnecessary burden on emergency medicine services

Shock index and shock index, pediatric age-adjusted as predictors of mortality in pediatric patients with trauma: A systematic review and meta-analysis

Quality of pediatric trauma care: development of an age-adjusted TRISS model and survival benchmarking in a major trauma center

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