Pediatric Trauma: Enabling Factors, Social Situations, and Outcome
| Autor: | Beverly L Timerding, Timothy H. Hartzog, Roy L. Alson |
|---|---|
| Rok vydání: | 1996 |
| Předmět: |
Male
medicine.medical_specialty Adolescent media_common.quotation_subject Poison control Occupational safety and health Neglect Age Distribution Injury Severity Score Risk Factors Injury prevention medicine Humans Sex Distribution Child Retrospective Studies media_common Analysis of Variance business.industry Incidence Medical examiner Trauma center General Medicine Length of Stay medicine.disease Hospitalization Socioeconomic Factors Child Preschool Emergency medicine Costs and Cost Analysis Emergency Medicine Wounds and Injuries Female Medical emergency Safety business Pediatric trauma |
| Zdroj: | Academic Emergency Medicine. 3:213-220 |
| ISSN: | 1553-2712 1069-6563 |
| DOI: | 10.1111/j.1553-2712.1996.tb03423.x |
| Popis: | OBJECTIVES: 1) To determine, for severely injured pediatric patients, which enabling factors and social situations are associated with the most severe and costly injuries; 2) to determine which subsets of patients are affected by particular enabling factors; and 3) to determine which enabling factors are associated with death. METHODS: Retrospective chart review of patients included in a pediatric trauma registry at a level I trauma center, plus review of medical examiner reports for deaths declared at the scene for one year. Abstracted data included age, gender, enabling factors (e.g., abuse/assault, neglect, endangerment, and nonuse of safety measures), mechanisms of injury, Injury Severity Scale (ISS) score, length of stay, need for intensive care unit (ICU) care, and expense. RESULTS: Records were reviewed for 336 identified children. There was a 2:1 male-to-female ratio; 9.5% died, 3.5% at the scene. Active endangerment or neglect was associated with death (p = 0.0004). However, the nonuse of safety devices was more common and resulted in a higher absolute number of deaths. Similarly, while inadvertent gunshot wounds, intentional injury, and environmental mishaps were more commonly lethal, motor vehicle crashes (MVCs) were more common and claimed the most lives. Cost was highest for the patients aged 14-16 years, in part reflecting the larger number of MVCs. CONCLUSION: The severity of pediatric trauma is largely influenced by the mechanism of injury. Our data highlight the importance of enabling factors for such injuries overall and as a function of age group (reflecting developmental status). While injury prevention education for caregivers is necessary, the incorporation of passive safety measures also is vital for decreasing injuries and their severity. Language: en |
| Databáze: | OpenAIRE |
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