Department of Anaesthesia, Centre of Head and Orthopaedics, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
Injury. 2012 Dec;43(12):2060-4. doi: 10.1016/j.injury.2011.12.005. Epub 2011 Dec 28.
Although trauma remains a major cause of morbidity and mortality in children, less attention has been directed to this group of patients. Whilst there is considerable literature on trauma in adults, only few studies describe paediatric trauma. The aim of this study was to describe the mortality pattern of severely injured children admitted to a Danish level I trauma centre.
We included trauma patients aged 15 years or less, who subsequent a trauma team activation were admitted during the 9-year period 1999-2007. Data were collected prospectively for subjects who had a length of stay ≥ 72 h, were admitted to the intensive care unit (regardless of length of stay), or died in hospital. Logistic regression analysis was performed to assess independent predictors for in-hospital mortality. p<0.05 was considered statistically significant.
We included 331 patients, 199 (60.1%) boys/132 girls with a median age of 7 years and injury severity score (ISS) of 9. A total of 307/331 (92.7%) survived to discharge, and 16/24 (66.7%) deaths occurred within 24h after admission. Age was significantly lower in patients dying due to trauma (median 5 (0-15) vs. 7 (0-15) years, p=0.04, adjusted odds ratio (OR)=0.89 [95% CI: 0.80-0.99]). ISS was significantly higher in patients who died (median 25 (16-71) vs. 9 (4-29), p<0.0001, adjusted OR=1.15 [95% CI: 1.10-1.20]).
Children who did not survive after severe trauma were significantly younger, more injured, and died early after admission.
尽管创伤仍然是儿童发病和死亡的主要原因，但对这组患者的关注较少。虽然有大量关于成人创伤的文献，但只有少数研究描述了儿科创伤。本研究的目的是描述丹麦一级创伤中心收治的严重受伤儿童的死亡率模式。
我们纳入了年龄在 15 岁或以下的创伤患者，这些患者在创伤团队激活后，于 1999 年至 2007 年的 9 年期间被收治入院。对于住院时间≥72 小时、入住重症监护病房（无论住院时间长短）或在医院死亡的患者，前瞻性收集数据。使用逻辑回归分析评估院内死亡的独立预测因素。p<0.05 被认为具有统计学意义。
我们纳入了 331 名患者，其中 199 名（60.1%）为男性/132 名女性，中位年龄为 7 岁，损伤严重度评分（ISS）为 9 分。共有 307/331（92.7%）患者存活出院，24 小时内死亡的患者有 16/24（66.7%）。因创伤死亡的患者年龄明显较低（中位数 5（0-15）岁与 7（0-15）岁，p=0.04，调整后的优势比（OR）=0.89 [95% CI：0.80-0.99]）。ISS 在死亡患者中明显更高（中位数 25（16-71）分与 9（4-29）分，p<0.0001，调整后的 OR=1.15 [95% CI：1.10-1.20]）。
严重创伤后未能存活的儿童明显更年轻、受伤更严重，并且在入院后早期死亡。
