Hannah Wild1, Barclay T Stewart2, Christopher LeBoa3, Christopher D Stave4, Sherry M Wren5. 1. Department of Surgery, University of Washington, Seattle, WA USA. Electronic address: hbwild@uw.edu. 2. Department of Surgery, University of Washington, Seattle, WA USA; Global Injury Control Section, Harborview Injury Prevention and Research Center, Seattle, WA, USA. 3. Department of Epidemiology, Stanford University, Stanford, CA, USA. 4. Lane Medical Library, Stanford University School of Medicine, Stanford, CA, USA. 5. Stanford University School of Medicine, Stanford, CA, USA.
Abstract
BACKGROUND: Children represent a significant percentage of casualties in modern conflict. Yet, the epidemiology of conflict-related injury among children is poorly understood. A comprehensive analysis of injuries sustained by children in 21st-century armed conflict is necessary to inform planning of local, military, and humanitarian health responses. METHODS: We conducted a systematic search of databases including PubMed, Embase, Web of Science, World Health Organization Catalog, and Google Scholar to identify records that described conflict-related injuries sustained by children since 2001. RESULTS: The search returned 5,264 records. 9 eligible reports without potentially duplicative data were included in analysis, representing 5,100 pediatric patients injured in 5 conflicts. Blast injury was the most frequent mechanism (57%), compared to 24.8% in adults. Mortality was only slightly higher among children (11.0% compared to 9.8% among adults; p <0.05). Non-uniform reporting prevented pooled analysis and limited the conclusions that could be drawn. CONCLUSIONS: Children sustain a higher proportion of blast injury than adults in conflict. Existing data do support the conclusion that child casualties have higher mortality than adults overall; however, this difference is slighter than has been previously reported. Specific subpopulations of children appear to have worse outcomes. Overall, non-uniform reporting renders currently available data insufficient to understand the needs of children injured in modern conflict.
BACKGROUND:Children represent a significant percentage of casualties in modern conflict. Yet, the epidemiology of conflict-related injury among children is poorly understood. A comprehensive analysis of injuries sustained by children in 21st-century armed conflict is necessary to inform planning of local, military, and humanitarian health responses. METHODS: We conducted a systematic search of databases including PubMed, Embase, Web of Science, World Health Organization Catalog, and Google Scholar to identify records that described conflict-related injuries sustained by children since 2001. RESULTS: The search returned 5,264 records. 9 eligible reports without potentially duplicative data were included in analysis, representing 5,100 pediatric patients injured in 5 conflicts. Blast injury was the most frequent mechanism (57%), compared to 24.8% in adults. Mortality was only slightly higher among children (11.0% compared to 9.8% among adults; p <0.05). Non-uniform reporting prevented pooled analysis and limited the conclusions that could be drawn. CONCLUSIONS:Children sustain a higher proportion of blast injury than adults in conflict. Existing data do support the conclusion that child casualties have higher mortality than adults overall; however, this difference is slighter than has been previously reported. Specific subpopulations of children appear to have worse outcomes. Overall, non-uniform reporting renders currently available data insufficient to understand the needs of children injured in modern conflict.
Authors: Sebastiano A G Lava; Daniele de Luca; Gregorio P Milani; Piet Leroy; Nicole Ritz; Peter de Winter Journal: Eur J Pediatr Date: 2022-06 Impact factor: 3.860