P0213 / #2008: THE EPIDEMIOLOGY OF PEDIATRIC POLYTRAUMA AND ORTHOPEDIC INJURIES: 12-YEAR ANALYSIS OF A LEVEL-1 TRAUMA CENTER (2007-2019)

Abstract

Aims & Objectives: We present a retrospective study of pediatric polytrauma patients admitted to the pediatric Intensive Care Unit (ICU) of a tertiary university hospital in Europe. Methods: Data retrieved from 2007 to 2019 included mechanism and site of injury, pre-hospital and in-hospital trauma care, ICU length-of-stay (LOS), and in-hospital mortality. Results: 217 patients were included (age 10,7 ± 4,86 years; 66% male). Motor vehicle accidents (MVA) (44,4%) and car-pedestrian accidents (25,9%) were the leading mechanisms of injury, followed by falls from height (21,8%; 4,2% sports-related), penetrating trauma (3,3%) and suicide attempts (2,3%). On pre-hospital assessment, 60% of children had documented loss of consciousness; of these, more than half had severe brain injury (GCS<9). The most frequent injury sites were brain (74%) and skeleton (73%). Vertebral fractures were the most common orthopedic injury (19%), followed by pelvic (16,6%) and femur (15,2%) fractures. Patients with orthopedic trauma had significantly longer ICU LOS (5,1 ± 2,76 vs 3,1 ± 1,16; p=0,007); those with 3 or more fracture sites had greater needs for blood transfusion (20 vs 4 mL/kg; p=0,016). MVA were associated with highest incidence of orthopedic severe injuries (p<0,001). Most children involved in MVA were completely unrestrained (37,5%) or using a restraint system inappropriately (6,3%). Overall ICU trauma-related mortality was 1,8% (three cases of severe brain injury and one cervical spine injury). Conclusions: The great majority of polytrauma children suffer orthopedic injuries, requiring longer ICU admission and higher transfusion volumes. Road traffic accidents remain the leading cause of severe polytrauma. Education-oriented programs are still of crucial importance for prevention.