Hatice Feray Arı, Ayşe Doğan, Barış Erdoğan, Gonca Gerçel
Trends in Pediatrics - 2025;6(3):141-150
Objective: Trauma is defined as a life-threatening condition and the leading cause of death in children. The present study aimed to investigate the relationship between clinical findings documented at admission and the interventions implemented in relation to patient outcomes, with the goal of determining the benefits of multidisciplinary treatment in a pediatric intensive care unit (PICU) for patients with trauma. Method: A retrospective single-center study was conducted, including patients aged 1 month to 18 years who were treated for trauma between March and September 2022 in the PICU. The demographic characteristics, traumatic brain injury/multi-traumas, length of stay, Pediatric Risk of Mortality Score III (PRISM III), neurological findings, laboratories, radiological imaging, mortality, and outcomes were evaluated. Pediatric Trauma Score (PTS), Shock Index (SI), and Shock Index Pediatric Adjusted (SIPA) were calculated. These scores are evaluated for length of stay, transfusions, head injury, and mortality. In addition, the Vasoactive Intotropic Score (VIS), Rotterdam Computed Tomography Score (RCTS), and Functional Status Scale (FSS) were analysed to determine outcomes and effect on mortality. Results: This study included 55 patients with a mean age of 73.95 (IQR:63.00) months. The mean PRISM III score was 24.95 (IQR:14.00) and the length of stay was 13.27 (IQR: 4.00) days. The most prevalent type of injury was falls from a height, accounting for 47.3% of cases. Furthermore, 28 subjects (50.9%) exhibited brain trauma, while a total of 30 subjects (54.5%) had multiple injuries. Surgery was performed on 21 (38.2%) cases. The mortality rate was 12 (21.8%). The requirement for inotropes (p=0.001), transfusions (p=0.004), and abnormal findings in brain computed tomography (CT) (p=0.036) have been demonstrated to have a significant impact on mortality, with intracranial hemorrhage having a substantial effect on the sequelae (p=0.019). In patients exhibiting elevated risk scores for predicting mortality and protracted PICU admission, PTS (p=0.001; p=0.001), SI (p=0.001; p=0.022), and SIPA (p<0.001; p<0.001) were identified as statistically significant. Despite the absence of a statistically significant relationship between the presence of head trauma and high risk (p>0.05), the need for transfusion was found to be associated with high SIPA (p=0.013). A positive and statistically significant correlation was identified between VIS (r= 0.914), RCTS (r= 0.751), and FSS (r= 0.946) and mortality (p<0.001). Conclusion: The study demonstrates a statistically significant correlation between PTS, SIPA, VIS, RCTS, FSS, and mortality, as well as length of stay and outcomes. Children who have suffered a serious traumatic injury must be examined using age-based evaluation systems in a timely manner and be transferred to centres that can provide them with appropriate treatment as soon as possible.
