Epidemiology of Major Paediatric Trauma in a European Country – Trends of a Decade

Abstract

Abstract Objectives This study describes the epidemiology of severe injuries related to trauma in children and assesses potential preventive areas. Methods Single-centre retrospective study of paediatric trauma patients admitted to a Paediatric Intensive Care Unit (PICU) in a tertiary university hospital in Europe, from 2009 to 2019. Results Total 358 patients included (age 11 ± 4,9 years; 67% male); 75% were involved in road traffic accidents: 30% motor vehicle collision, 25% pedestrian, 10% motorcycle and bicycle each. Falls from height injured 19% of children, 4% during sports activities. Main injuries were to head/neck (73%) and extremities (42%). The incidence of major trauma was highest in teenagers and did not show a decreasing trend during the study years. All fatalities (1,7%; n = 6) were related to head/neck injuries. Motor vehicle collisions resulted in higher need for blood transfusion (9 vs 2 mL/kg, p = 0,006) and the highest ICU-mortality (83%; n = 5). Children in motorcycle accidents had longer ICU length-of-stay (6,4 vs 4,2 days, p = 0,036). Pedestrians had 25% higher risk of head/neck injuries (RR 1,25; 1,07 − 1,46; p = 0,004), and higher incidence of severe brain injury (46% vs 34%, p = 0,042). Most children in motor-vehicle/bicycle accidents were not using restraints/protective devices (45%) or were using them inappropriately (13%). Conclusions Over the last decade, the absolute numbers of paediatric major trauma did not decrease. Road traffic accidents remain the leading cause of injury and death. Teenagers are at highest risk for severe trauma. Appropriate use of child restraints and protective equipment remain key for prevention.