A study of factors affecting outcome in pediatric polytrauma

Abstract

Background:Trauma is a leading cause of morbidity and mortality in children. Polytrauma affects the prognosis due to multisystem involvement.

Methods: A retrospective observational study was conducted from January 2012 to December 2015. All cases of polytrauma below 12 years of age were included in the study. The data was analyzed in terms of age, sex, mode of injury, time of presentation, ISS scoring at presentation, USG, CT/MRI findings, analysis of type and severity of injuries in individual systems, associated system injuries, management, outcome and mortality.

Results:75 cases of polytrauma were included in the study. 48 (64%) were males and 27 (36%) were females. The commonest age group affected was 3-8 years. The most common mode of injury was road traffic injury (80%). The average time of presentation to the hospital was 4-7 hours. The most common injury was extremity injury (52%). The most common systemic injury was head trauma (40%).The commonly associated injuries with head trauma were extremity injuries followed by chest trauma. All five cases with pelvic trauma had genitourinary tract involvement.18 patients required minor surgical interventional procedures. 3 patients required laparotomy, 3 required neurointervention for evacuation of large hematomas and 5 patients required surgery for perineal injuries. There were 5 deaths in the series.

Conclusions:Pediatric polytrauma is a significant cause of morbidity in children. Head injury is the most common injury and also the prime determinant of prognosis. Solid organ injury in children seldom requires operative intervention. Management of polytrauma requires active interdepartmental co-ordination. The prognosis in most cases is excellent.