Abstract
BackgroundTrauma is a major cause of mortality and morbidity in children globally. The burden of injury shows substantial geographical differences, with a significant mortality reduction in children in Norway during the last four decades. The aim was to describe the current epidemiology, resource use and outcome for all potential severely injured paediatric patients admitted to a Norwegian trauma centre.MethodsThis was a single-centre retrospective observational study. All patients aged 0–17 years received by a trauma team between 01 January 2004 and 31 December 2016 (13 years) at St. Olav’s University Hospital were included. Severe injury was defined as Injury Severity Score > 15.ResultsA total of 873 patients were included, of which 536 (61%) were male. The median age was 13 years (IQR 7–16). Six per cent (n = 52) of the patients were transferred from other hospitals. Blunt trauma constituted 98%, with traffic (n = 532/61%) and falls (n = 233/27%) as the most common mechanisms. Eight patients (1%) died within 30 days of hospital admission. Fifteen per cent (n = 128) were severely injured. Among the patients transferred from another hospital, 46% (n = 24) had severe injuries. Helicopter Emergency Medical Services (HEMS) were more used in younger age groups and in patients more severely injured.ConclusionsIn a developed healthcare system, the number of potentially severely injured children is small and with very few deaths following trauma. Transport and falls represent the most common causes of injury throughout all age groups, though with a tendency towards more transport-related injuries with increasing age. In-hospital trauma care is characterized by a low threshold for a multidisciplinary reception, low use of intensive care and need for emergency surgical procedures, though with increased need in the older children.
Highlights
Trauma is a major cause of mortality and morbidity in children globally
The regional Emergency Medical Coordination Centre (EMCC) staffed by specially trained nurses and paramedics activate the trauma team according to pre-defined triage criteria
Six per cent (n = 52) of the patients were transferred to the trauma centre from a local emergency hospital, with the remaining 94% (n = 821) being transported directly from the scene (Table 1)
Summary
Trauma is a major cause of mortality and morbidity in children globally. The burden of injury shows substantial geographical differences, with a significant mortality reduction in children in Norway during the last four decades. Trauma is a major cause of mortality and morbidity in children globally, with road injuries having the highest incidence rates [1]. The burden of injury experiences both substantial geographical and sociodemographic differences, with the highest incidence rates in low-income countries and lowest in the industrialized countries in Western Europe [1]. Though the incidence of severe trauma among the paediatric population is declining in Europe, it still represents a major public health problem in the European Union [3]. As mortality rates have declined during the last two decades, morbidity after trauma is receiving more attention [4].
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