Document Type : Original Article
Authors
1 Department of General Surgery, K.B. Bhabha Hospital, Mumbai, India
2 Department of General Surgery, GCS Medical College & Hospital, Ahmedabad, India
3 Department of Critical Care, K.B. Bhabha Hospital, Mumbai, India
Abstract
Objective: To study the demographic profile and outcomes of pediatric trauma victims.
Methods: A prospective observational study was performed at a secondary care centre in urban India over 15 months. Permission from the local ethics body was obtained prior to the commencement of the study. Children under the age of 12 years admitted with trauma to the General Surgical department were included. Demographic data, history of events leading to trauma, clinical findings and treatment were recorded. Pediatric Trauma Score (PTS), Functional Independence Measure (FIM) and Pediatric Quality of Life Index (PQLI) were used to assess the outcomes.
Results: A total of 178 patients were included in the study. Preschool age group (3-5 years) (45%) was the most commonly affected. Majority of traumas occurred at home (75%). These homes were informal slum houses where children stayed in lofts. Fall from height (49%) due to fall from lofts (44%) was observed to be the most common mode of injury at home. Majority of patients had minor trauma with PTS (9-12) presenting with head injury (88%). However, only 35% had positive radiologic findings. There was a significant difference in PQLI of all patients and in FIM of preschool age group patients, irrespective of severity of trauma before admission and at one month of follow up.
Conclusion: Child’s home was found as the most common site of trauma. Physical, psychosocial and cognitive impairment were seen in all pediatric trauma patients and functional impairment was seen mainly in preschool age. Majority of pediatric injuries are preventable.
Keywords
- Pediatric trauma
- PTS (Pediatric Trauma Score)
- PQLI (Pediatric Quality of Life index)
- FIM (Functional Independent Measure
Main Subjects
Jersey: Prentice Hall; 2008: 848-52.
2. Peden M, Oyegbite K, Ozanne-Smith J, Hyder AA, Branche C, Rahman A, et al. World Report on
Child Injury Prevention. Geneva: World Health Organization; 2008. Available from: http://whqlibdoc.
who.int/publications/2008.
3. Hyder AA, Sugerman DE, Puvanachandra P, Razzak J, El-Sayed H, Isaza A, et al. Global childhood
unintentional injury surveillance in four cities in
developing countries: a pilot study. Bull World Health Organ 2009; 87(5): 345-52. doi: 10.2471/blt.08.055798.
4. Max JE, Wilde EA, Bigler ED, MacLeod M, Vasquez AC, Schmidt AT, et al. Psychiatric disorders after
pediatric traumatic brain injury: a prospective, longitudinal, controlled study. J Neuropsychiatry
Clin Neurosci 2012; 24(4): 427-36. doi: 10.1176/appi.neuropsych.12060149.
5. Anderson V, Godfrey C, Rosenfeld JV, Catroppa C. Predictors of cognitive function and recovery 10
years after traumatic brain injury in young children.Pediatrics 2012; 129(2): e254-61. doi: 10.1542/
peds.2011-0311.
6. Vitale M, Mooney DP. Long-term outcomes in injured children. In: Wesson DE, Naik-Mathuria B,
eds. Pediatric Trauma: Pathophysiology, Diagnosis, and Treatment. Abingdon: Taylor and Francis Group;
2006; 23: 390.
7. Polinder S, Meerding WJ, Toet H, Mulder S, Essink-Bot ML, van Beeck EF. Prevalence and prognostic
factors of disability after childhood injury. Pediatrics 2005; 116(6): e810-7. doi: 10.1542/peds.2005-1035.
8. Sund G, Kirkpatrick T, Tobias K. Pediatric Age Specific: Self Learning Module. UCLA Health System;
2011: 2.
9. Youngblut JM, Singer LT, Boyer C, Wheatley MA, Cohen AR, Grisoni ER. Effects of pediatric head
trauma for children, parents, and families. Crit Care Nurs Clin North Am 2000; 12(2): 227-35.
10. Potoka DA, Schall LC, Gardner MJ, Stafford PW, Peitzman AB, Ford HR. Impact of pediatric trauma
centers on mortality in a statewide system. J Trauma 2000; 49(2): 237-45. doi: 10.1097/00005373-
200008000-00009.
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