Causes and Outcomes of Childhood Trauma with GCS Below 9

Abstract

Background: Trauma, as one of the major public health challenges, was the leading cause of death and disability in most countries. Trauma was considered as the most common reason for emergency department admission. Children are the most susceptible group of society to trauma, so we designed a study to investigate the epidemiologic feature and outcomes of trauma in children under 18 years old. In light of these findings, we might be able to prevent trauma in children. 
 Materials and methods: We conducted a retrospective cross-sectional study during the spring season of 2019 (for 3 months). The study population was all children under eighteen years old with GCS below 9 (1814cases), referring to the emergency department of Tabriz Emam-Reza Hospital. Among 1814 patients, 1786 patients were included. For each included patient, the outcomes of the 24-hour follow-up have been recorded. 
 Result: In this study, 62.1% percent (n=1109) were males. The mean age of patients was 5.47 ± 3.1. There were 1271 (71.1%) head and neck trauma, 276 (15.5%) extremities trauma. Abdominal trauma (n=66, 3.7%) and spinal trauma (n=57, 3.2%) were the rarest types of mechanism. It was revealed that falling had the most incidence frequency (40.4%). Eventually, out of the entire study population, 1361 patients were discharged from the emergency department (75%), 5 patients transferred to the trauma ward (0.2%), 1 patient hospitalized in the intensive care unit (0.05%), 250 patients left the hospital against physician permission (14%), 110 patients referred to another center (6%), 59 patients escaped from the hospital (3%) and zero deaths. 
 Conclusion: Our study suggests that the head and neck were the most injured anatomic locations in children. Males were more susceptible to being exposed to trauma. Falling and traffic accidents were the most frequent mechanism of trauma that occurred in under eighteen-year-old children. Awareness of patterns of pediatric trauma may help the adoption of safety policies and develop prevention strategies. In this regard, training prevention strategies for parents and improving playground safety will be effective.