BACKGROUND: Paediatric trauma is a major cause of morbidity and mortality in low and middle income countries. Data from these regions describing the extent and severity of this problem is scant. Local data is vital to understanding and responding to the problem of childhood injury.
METHOD: A retrospective record review of all trauma cases admitted to the PICU at CHBAH from 1 January 2011 to 31 December 2013 was performed. Descriptive statistics were generated using MS Excel. Students' t test was used for analytic statistics. Ethics clearance was obtained prior to data collection. All children aged 0-16 years were included.
RESULTS: A total of 185/919 (20.1%) of all admissions to the PICU were due to childhood trauma. Complete records were found on 66.5% of patients. 57.7% of all admissions were male. Timing of admissions was split almost equally between weekends (49.5%) and weekdays (50.5%). Road traffic injuries (RTI) (65.8%) and toxin ingestion (TI) (17.1%) accounted for the majority of admissions. Children aged 0-4 years accounted for 44.7%, 5-9 years 39.0%, and 10-15 years 16.3% of admissions. The mortality rate was 8.9%. RTI accounted for 63.6% of all mortalities. 64% of mortalities occurred in the 0-4 year cohort, and 36% in the 5-9 year cohort. Mean age of survivors (5.8 years) was significantly higher than nonsurvivors (3.3 years) (p < 0.05). No significant difference was found in mean length of stay of survivors (6.5 days) and non-survivors (10.9 days) (p = 0.05). 89.4% of all children required invasive ventilation on PICU admission. Mean length of ventilation in non-survivors (10.2 days) was significantly longer than survivors (4.5 days). 83.9% (516/615 days) of total days of ventilation were due to RTI and toxin ingestion.
CONCLUSION: Preventable injury imposes a significant burden on the health care system, society, families and affected individuals. Local data is vital to recognition of the burden of disease caused by preventable injury and formulating appropriate intervention strategies. Road traffic injuries accounted for the majority of trauma admissions to our PICU. Multi-sectoral sustained action is required to decrease morbidity and mortality associated with preventable childhood injury.