Buschmann Christian, Kühne Christian A, Lösch Christian, Nast-Kolb Dieter, Ruchholtz Steffen
Department of Orthopedic Surgery, University of Aachen, Aachen, Germany.
J Pediatr Orthop. 2008 Jan-Feb;28(1):1-5. doi: 10.1097/BPO.0b013e31815b4d90.
The aim of this study was to evaluate the demographics, mechanisms, pattern, injury severity, and the outcome (ie, length of intensive care unit [ICU] stay, length of mechanical ventilation, total length of stay, mortality) in multiple-injured children based on a review from the German trauma registry study ("Traumaregister") of the German Society of Trauma Surgery (Deutsche Gesellschaft für Unfallchirurgie e.V.).
One hundred three German trauma centers took part in the German trauma registry study from January 1997 to December 2003. Five hundred seventeen children (aged 0-15 years) with multiple injuries and an Injury Severity Score of more than 15 in comparison to 11,025 adults were included. Sex, age, and mechanisms and pattern of injury were assessed. The mechanisms of trauma and the anatomical distribution of severe injury (Abbreviated Injury Scale of 3 or more) were analyzed. The Injury Severity Score, the Revised Trauma Score, and the Trauma Score Injury Severity Score were calculated to estimate the severity of injury and mortality.
The predominant sex was male. Most cases were caused by traffic-related accidents. Head injuries were most common in children, and severe thoracic injuries increased with age. Mean length of ICU treatment, mechanical ventilation, and total length of stay were shorter in children than in adults. A total of 22.6% of the children aged 0 to 5 years died in the hospital in comparison with in-hospital mortality rate of 13.7% in the 6- to 10-, 20.3% in the 11- to 15-, and 17.0% in the 16- to 55-year-old patients.
There were differences between multiple-injured children and adults concerning injury mechanisms and pattern of injuries. Adults needed a longer mechanical ventilation and a longer ICU therapy. Most deaths could be seen in the youngest patients aged 0 to 5 years.
本研究旨在基于德国创伤外科学会（Deutsche Gesellschaft für Unfallchirurgie e.V.）的德国创伤登记研究（“Traumaregister”）的回顾，评估多发伤儿童的人口统计学特征、损伤机制、损伤类型、损伤严重程度及预后（即重症监护病房[ICU]住院时间、机械通气时间、总住院时间、死亡率）。
1997年1月至2003年12月，103个德国创伤中心参与了德国创伤登记研究。纳入了517名多发伤儿童（年龄0至15岁），其损伤严重度评分超过15分，并与11025名成人进行比较。评估了性别、年龄、损伤机制及损伤类型。分析了创伤机制及严重损伤（简明损伤定级为3级或更高）的解剖分布。计算损伤严重度评分、改良创伤评分及创伤评分损伤严重度评分，以评估损伤严重程度及死亡率。
主要为男性。大多数病例由交通事故所致。儿童中头部损伤最为常见，严重胸部损伤随年龄增加而增多。儿童的ICU治疗平均时间、机械通气时间及总住院时间均短于成人。0至5岁儿童的院内死亡率为22.6%，而6至10岁患者的院内死亡率为13.7%，11至15岁患者为20.3%，16至55岁患者为17.0%。
多发伤儿童与成人在损伤机制及损伤类型方面存在差异。成人需要更长时间的机械通气及ICU治疗。大多数死亡发生在0至5岁的最年幼患者中。
