Pattern and outcome of unintentional pediatric trauma in the emergency department of a tertiary care hospital in South India

Abstract

Background: Pediatric trauma is a significant cause of morbidity, and few studies on profile and outcome have been done in the emergency departments (EDs) of India. Methodology: This prospective observational study was conducted between October 2014 and December 2014 in the adult and pediatric ED's of Christian Medical College, Vellore. All patients younger than 18 years, who presented with unintentional injury, were enrolled in this study. Results: The adult and pediatric ED's attended to a combined 24,482 patients (16,169 adults and 8313 children and adolescents) during the 3-month study with 8.2% (2022/24,482) being trauma incidents. Pediatric and adolescent ( 18 years) trauma patients made up the remainder 80% (1624). Falls are the most common mechanism of injury among infants and toddlers with decreasing frequency with age. With increasing age, the place of injury changes from the surroundings of home to playgrounds, schools, and the roads. About 80% of injuries among infants occur at home while only 12% of adolescent injuries occur at home. Road traffic injuries account for 46% of injuries sustained by adolescents. Most of the children and adolescents (63%) were managed conservatively. Minor surgical intervention was required in 20% whereas 11% required major surgical intervention. Majority (77%) was discharged stable from the ED, and 21% were admitted. The in-hospital mortality of pediatric trauma was 1.2% (5/397). Conclusions: Pediatric and adolescent trauma is a significant cause of morbidity and mortality in India, accounting for almost one-fifth of injured patients. There exists a need for injury prevention programs focusing on peridomestic safety among children 12 years and adolescents.