Pediatric casualties in contemporary armed conflict: A systematic review to inform standardized reporting. Issue 7 (July 2021)

• Record Type: Journal Article
• Authors: Wild, Hannah; Stewart, Barclay T.; LeBoa, Christopher; Stave, Christopher D.; Wren, Sherry M.
• Is Part Of: Injury. Volume 52:Issue 7(2021)
• Page Start: 1748
• Page End: 1756
• Publication Date: 2021-07
• Subjects: Pediatrics -- Mortality -- Conflict -- War -- Trauma -- Humanitarian response; Wounds and injuries -- Surgery -- Periodicals; Accidents -- Periodicals; Wounds and Injuries -- surgery -- Periodicals; Lésions et blessures -- Chirurgie -- Périodiques; Electronic journals; Electronic journals; 617.1
• DOI: 10.1016/j.injury.2021.04.055
• Languages: English
• ISSNs: 0020-1383

Abstract

Highlights: Despite previous literature stating that child casualties in conflict have substantially higher mortality than adults, only a slightly higher mortality rate is observed when all available literature is reviewed (11.0% among children versus 9.8% among adults). Specific populations including children with burns and head injuries appear to have disproportionately high mortality. Non-uniform reporting severely limits the utility of existing data on the epidemiology of conflict-related injuries in children. Within the limitations of existing data, children sustain a higher proportion of blast injury than adults in conflict, with special needs for reconstruction and long-term rehabilitation. Abstract: Background: Children represent a significant percentage of casualties in modern conflict. Yet, the epidemiology of conflict-related injury among children is poorly understood. A comprehensive analysis of injuries sustained by children in 21 st -century armed conflict is necessary to inform planning of local, military, and humanitarian health responses. Methods: We conducted a systematic search of databases including PubMed, Embase, Web of Science, World Health Organization Catalog, and Google Scholar to identify records that described conflict-related injuries sustained by children since 2001. Results: The search returned 5, 264 records. 9 eligible reports without potentially duplicative data were included in analysis, representing 5, 100 pediatric patients injured in 5 conflicts. Blast injury was the most frequent mechanism (57%), compared to 24.8% in adults. Mortality was only slightly higher among children (11.0% compared to 9.8% among adults; p <0.05). Non-uniform reporting prevented pooled analysis and limited the conclusions that could be drawn. Conclusions: Children sustain a higher proportion of blast injury than adults in conflict. Existing data do support the conclusion that child casualties have higher mortality than adults overall; however, this difference is slighter than has been previously reported. Specific subpopulations of children appear to have worse outcomes. Overall, non-uniform reporting renders currently available data insufficient to understand the needs of children injured in modern conflict.