Outcomes in Pediatric Trauma Care in the Stockholm Region

Abstract

Background:
Although trauma is a leading cause of pediatric mortality and morbidity in Sweden, few studies have examined the outcome of
pediatric trauma.

Objective:
Here, we describe the age and gender distribution, injury mechanisms, injury severity, and outcome of pediatric trauma in
the Stockholm region.

Methods:
This retrospective study comprises all trauma patients (age ≤ 15 years) admitted to a regional pediatric trauma center and
all pediatric deaths due to trauma in Stockholm in 2002. Data from the trauma registry database were verified by comparison
with medical records and autopsy reports. Outcome was measured by mortality and length of stay in a pediatric intensive care
unit (PICU) and acute care hospital.

Results:
In all, 432 injured children were included. The median age was 10 years and 59% were males. The median injury severity score
was 4 (interquartile range [IQR] 1–9) and 50% sustained head injuries. Mortality was low (1%) and the median length of hospital
stay was 2 days (IQR 1–3); 19% stayed in a PICU and, of those, 89% stayed for one day. Comparison with medical records showed
that much information in the trauma registry database was either incorrect or missing.

Conclusions:
Many injuries were minor and half of the children were discharged home from the emergency department.Head injurieswere themost
common injury in all age groups. The most severe head injuries were seen in the youngest group and were caused by falls. Trauma
team activation criteria should be improved to avoid overutilization. The quality and completeness of data in the trauma registry
must be enhanced.

Key Words
Pediatric trauma-Triage-Outcomes-Mortality-Trauma registry