Polytrauma in children and adolescents. Choice of the primary care clinic and importance of pediatric traumatology competence centers

• Published in: Der Unfallchirurg Vol. 118; no. 5; pp. 432 - 438
• Main Authors: Debus, F, Lefering, R, Frink, M, Kühne, C, Mand, C, Ruchholtz, S
• Format: Journal Article
• Language: German
• Published: Germany 01-05-2015
• Subjects: Adolescent; Adolescent Health - statistics & numerical data; Age Distribution; Child; Child Health - statistics & numerical data; Child, Preschool; Clinical Decision-Making; Female; Germany - epidemiology; Hospitalization - statistics & numerical data; Humans; Infant; Infant, Newborn; Male; Multiple Trauma - diagnosis; Multiple Trauma - mortality; Multiple Trauma - therapy; Pediatrics - statistics & numerical data; Prevalence; Primary Health Care - utilization; Risk Assessment; Sex Distribution; Survival Rate; Traumatology - statistics & numerical data; Treatment Outcome
• ISSN: 1433-044X
• DOI: 10.1007/s00113-013-2518-7

The number of (seriously) injured children increased again for the first time in 2011. The aim of this study was to analyse differences compared to multiple injured adults and to show the reality of daily treatment.
All cases of the DGU Trauma Registry from the years 1997 to 2010 were examined. The documented cases were divided into different the age groups. The study investigated, e.g. the mechanism of accident, injury pattern, the number of hospital and ICU days, and lethality.
At 38.8% the largest percentage of severely injured children and adolescents belongs to the group of 16-17 year olds. The group of 0-5 year olds (15.9%) has the lowest percentage. The most common accident cause was traffic accidents (58.5%). The mechanism of accident and the injury patterns changes with age. Younger patients are often treated in supraregional trauma centers (0-5 year olds: 78.2% vs. 16-17 year olds: 73.1% vs. > 65 years: 63.2%). The average lethality rate was 14.8% (16.3% RISC).
The percentage of severely injured children in the overall population is only 7.4%. Because the majority of patients are primarily treated in supraregional trauma centers, trauma centers with specialisation in paediatric traumatology are mandatory.