Price Mette Schytt, Raaber Nikolaj, Gundtoft Per Hviid, Trier Frederik
Research Center for Emergency Medicine, Aarhus University, Aarhus, Denmark.
Department of Anesthesiology and Intensive Care, Gødstrup Hospital, Gødstrup, Denmark.
Scand J Trauma Resusc Emerg Med. 2025 Mar 10;33(1):39. doi: 10.1186/s13049-025-01348-9.
In recent decades, the number of fatal accidents among children and adolescents has declined. Nevertheless, trauma remains a significant cause of death among children and adolescents in high-income countries, despite significant advancements in prevention and care. Pediatric trauma patients differ substantially from adults in terms of their physiology, anatomy, and daily activities; therefore, they show distinct injury patterns and require different care. The aim of this study was to investigate mortality from trauma in pediatric patients admitted by trauma team activation at the Aarhus University Hospital Trauma Center (AUH-TC) in a highly developed country with exceptionally low child mortality, where trauma is a leading cause of death in this age-group. By evaluating trends in demographics, mechanisms of injury, injury severity, and outcomes, this study aims to provide insights into trauma care and outcomes.
This retrospective cohort study included 1,037 pediatric patients (< 18 years old) consecutively admitted by trauma team activation from 1 January 2011 to 31 December 2021. The pediatric patients accounted for 14% of the total trauma population, which consisted of 7307 patients in total. Data on demographics, Injury Severity Score (ISS), mechanism of injury, and 30-day mortality were analyzed. Descriptive statistics were reported.
Boys accounted for 58% of the patients (n = 595). Falls were the mechanism of injury in 47% (n = 308) of children under 13 years old, while traffic-related injuries accounted for 38% (n = 139) of adolescents aged 14-17 years. Severe injuries (ISS > 15) were associated with traffic accidents in 25% of cases. The number of traumas peaked on weekends (71%) and during the spring/summer (29%). The ISS was greater than 15 in 13% (n = 130) of the patients, and the overall 30-day mortality rate was 1.6% (n = 17).
This study found no significant change in pediatric trauma incidence at AUH-TC over a decade. In Denmark, the few children with an ISS above 15 are predominantly injured in traffic accidents, with risk increasing with age. There was a low incidence of patients with an ISS above 15, and mortality rates were lower than in similar studies. These findings on injury patterns and severity may aid in risk assessment, accident prevention, and hospital resource planning. Further research with extended follow-up is recommended to assess potential trends in trauma mechanisms over time.
近几十年来，儿童和青少年致命事故的数量有所下降。然而，尽管在预防和护理方面取得了重大进展，但在高收入国家，创伤仍然是儿童和青少年死亡的重要原因。儿科创伤患者在生理、解剖结构和日常活动方面与成人有很大不同；因此，他们表现出不同的损伤模式，需要不同的护理。本研究的目的是调查在一个儿童死亡率极低的高度发达国家，奥胡斯大学医院创伤中心（AUH-TC）通过创伤团队启动收治的儿科患者的创伤死亡率，在这个年龄组中创伤是主要死因。通过评估人口统计学、损伤机制、损伤严重程度和结果的趋势，本研究旨在深入了解创伤护理和结果。
这项回顾性队列研究纳入了2011年1月1日至2021年12月31日期间通过创伤团队启动连续收治的1037例儿科患者（<18岁）。儿科患者占总创伤人群的14%，总共有7307例患者。分析了人口统计学、损伤严重程度评分（ISS）、损伤机制和30天死亡率的数据。报告了描述性统计结果。
男孩占患者的58%（n = 595）。13岁以下儿童中，47%（n = 308）的损伤机制是跌倒，而14 - 17岁青少年中，38%（n = 139）的损伤与交通有关。25%的严重损伤（ISS > 15）病例与交通事故有关。创伤数量在周末达到峰值（71%），在春季/夏季也较高（29%）。13%（n = 130）的患者ISS大于15，总体30天死亡率为1.6%（n = 17）。
本研究发现，十年来AUH-TC的儿科创伤发病率没有显著变化。在丹麦，ISS高于15的儿童主要在交通事故中受伤，风险随年龄增加。ISS高于15的患者发病率较低，死亡率也低于类似研究。这些关于损伤模式和严重程度的发现可能有助于风险评估、事故预防和医院资源规划。建议进行进一步的长期随访研究，以评估创伤机制随时间的潜在趋势。
