In-hospital mortality pattern of severely injured children.

BACKGROUND

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.

METHODS

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.

RESULTS

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]).

CONCLUSIONS

Children who did not survive after severe trauma were significantly younger, more injured, and died early after admission.