Anna K Butlinski1, Warwick W Butt2. 1. Murdoch Childrens Research Institute, Melbourne, VIC, Australia. anna.butlinski@rch.org.au. 2. Murdoch Childrens Research Institute, Melbourne, VIC, Australia.
Abstract
OBJECTIVE: To describe the characteristics, pattern of injury and outcome of children admitted to a paediatric intensive care unit (PICU) following an inflicted injury. DESIGN, SETTING AND PARTICIPANTS: A retrospective review of hospital records from a 30-bed PICU in a university teaching hospital, examining data for children admitted to the PICU after an inflicted injury from 1 January 2005 to 31 December 2013. MAIN OUTCOME MEASURES: The hospital records of 46 children with an inflicted injury were reviewed. Outcome was categorised using the Pediatric Overall Performance Category score. RESULTS: Sixty-one percent of children admitted to the PICU after an inflicted injury were aged under 12 months. Eighty-three percent of children required admission for a head injury. Radiological findings suggestive of pre-existing inflicted injury were evident in 50% of children. Follow-up information was available for 41 children; 76% were alive at follow-up while 24% had died. Among survivors, outcome was evaluated at a median of 11.3 months after admission to the PICU; 74% had a favourable outcome, despite 61% of these children having a disability. The remaining 26% of children had an unfavourable outcome and were likely to live dependent on care. CONCLUSIONS: The majority of children admitted to intensive care following an inflicted injury are aged under 12 months. Children most commonly require intensive care for management of a head injury. Many children have radiological findings suggestive of pre-existing inflicted injury. Despite high mortality, the majority of children survive. While most are likely to be independent, many children will have residual disabilities.
OBJECTIVE: To describe the characteristics, pattern of injury and outcome of children admitted to a paediatric intensive care unit (PICU) following an inflicted injury. DESIGN, SETTING AND PARTICIPANTS: A retrospective review of hospital records from a 30-bed PICU in a university teaching hospital, examining data for children admitted to the PICU after an inflicted injury from 1 January 2005 to 31 December 2013. MAIN OUTCOME MEASURES: The hospital records of 46 children with an inflicted injury were reviewed. Outcome was categorised using the Pediatric Overall Performance Category score. RESULTS: Sixty-one percent of children admitted to the PICU after an inflicted injury were aged under 12 months. Eighty-three percent of children required admission for a head injury. Radiological findings suggestive of pre-existing inflicted injury were evident in 50% of children. Follow-up information was available for 41 children; 76% were alive at follow-up while 24% had died. Among survivors, outcome was evaluated at a median of 11.3 months after admission to the PICU; 74% had a favourable outcome, despite 61% of these children having a disability. The remaining 26% of children had an unfavourable outcome and were likely to live dependent on care. CONCLUSIONS: The majority of children admitted to intensive care following an inflicted injury are aged under 12 months. Children most commonly require intensive care for management of a head injury. Many children have radiological findings suggestive of pre-existing inflicted injury. Despite high mortality, the majority of children survive. While most are likely to be independent, many children will have residual disabilities.