Nirav Patel1, I Khofi-Phiri2, L R Mathiva2, A Grieve3, J Loveland3, G D Nethathe2. 1. Department of Paediatric Surgery, Faculty of Health Sciences, University of the Witwatersrand, 29 Princess of Wales Terrace, Johannesburg, 2193, South Africa. niravpatel44@gmail.com. 2. Intensive Care Unit, Chris Hani Baragwanath Academic Hospital, Division of Critical Care, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa. 3. Department of Paediatric Surgery, Faculty of Health Sciences, University of the Witwatersrand, 29 Princess of Wales Terrace, Johannesburg, 2193, South Africa.
Abstract
BACKGROUND: Paediatric trauma is a major cause of morbidity and mortality in low and middle income countries. Data from these regions are scant. We aimed to describe the demographic and injury profile, treatment modality and outcome of trauma admissions to the paediatric intensive care unit at Chris Hani Baragwanath Academic Hospital (CHBAH). METHODS: A retrospective record review of trauma cases admitted to the PICU at CHBAH from 2011 to 2013 was performed. RESULTS: One-fifth of admissions were due to trauma. 58% of admissions were male. Weekends accounted for 49% of admissions. Road traffic injuries (RTI) (66%) and toxin ingestion (TI) (17%) contributed the majority of admissions. Children aged 0-4 years accounted for 45%, 5-9 years 39%, and 10-15 years 16% of admissions. The mortality rate was 9.0% with RTI accounting for 64%. 64% of mortalities occurred in the 0-4 year cohort. Mean age of survivors (5.8 years) was significantly higher than non-survivors (3.4 years) (p < 0.05). 89% of all children required invasive ventilation on PICU admission. Mean length of ventilation in non-survivors (10.2 days) was significantly longer than survivors (4.5 days) (p < 0.05). CONCLUSIONS: RTI accounted for the majority of trauma admissions to our PICU. RTI, female gender and age less than 4 years were all associated with an increased risk for mortality in our study.
BACKGROUND: Paediatric trauma is a major cause of morbidity and mortality in low and middle income countries. Data from these regions are scant. We aimed to describe the demographic and injury profile, treatment modality and outcome of trauma admissions to the paediatric intensive care unit at Chris Hani Baragwanath Academic Hospital (CHBAH). METHODS: A retrospective record review of trauma cases admitted to the PICU at CHBAH from 2011 to 2013 was performed. RESULTS: One-fifth of admissions were due to trauma. 58% of admissions were male. Weekends accounted for 49% of admissions. Road traffic injuries (RTI) (66%) and toxin ingestion (TI) (17%) contributed the majority of admissions. Children aged 0-4 years accounted for 45%, 5-9 years 39%, and 10-15 years 16% of admissions. The mortality rate was 9.0% with RTI accounting for 64%. 64% of mortalities occurred in the 0-4 year cohort. Mean age of survivors (5.8 years) was significantly higher than non-survivors (3.4 years) (p < 0.05). 89% of all children required invasive ventilation on PICU admission. Mean length of ventilation in non-survivors (10.2 days) was significantly longer than survivors (4.5 days) (p < 0.05). CONCLUSIONS: RTI accounted for the majority of trauma admissions to our PICU. RTI, female gender and age less than 4 years were all associated with an increased risk for mortality in our study.
Entities:
Keywords:
Critical care; Paediatric surgery; Paediatric trauma; Paediatrics; Public health; Road traffic injury; South Africa; Toxin ingestion
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