Road Traffic Injuries Among Semi-Urban African Children: Assessment Of Severity With The Pediatric Trauma Score

Abstract

Background: In Africa, road traffic injuries (RTI) have become significant causes of childhood morbidity and mortality. Nevertheless, trauma severity scoring is rarely applied in the management. Objectives: To evaluate the severity of childhood RTI using the Pediatric Trauma Score (PTS) in Ilesa; a semi-urban community in Southwest Nigeria. Methodology: A 12-month prospective study of consecutive children with RTI seen at the Children Emergency Room (CHER) of the Wesley Guild Hospital. Information was obtained and analysed regarding the pattern of RTI, the PTS and outcome. Results: A total of 263 children had RTI representing 8.0 percent of all CHER attendances. Pedestrians accounted for 60.8 percent cases. The mean PTS was 8.59 (± 2.85). Majority (63.5 percent) of the children sustained minor trauma (high PTS > 9). Statistically significant higher percentages of children who sustained major trauma (low PTS ≤ 8) were pedestrians, motorcycle victims, presented late, had penetrating, or multiple injuries, head injury, lost consciousness or convulsed. All 26 (9.9 percent) children who died following RTI (representing 17.6 percent of all CHER deaths) had low PTS (2.65 ± 3.02). All deaths were within 24 hours of RTI with no late deaths. Conclusions: RTI pose significant health hazard to children in the community studied. The PTS showed good relationship to RTI outcome. Because of its simplicity and reliability in assessing trauma severity and prognosis, we advocate its use for the evaluation of childhood RTI.