1082 Pattern and outcomes of adolescent trauma in a mixed major trauma centre: a one-year review of TARN data. (17th August 2022)

• Record Type: Journal Article
• Authors: Bertolusso, Beatrice; James, David; Chase, Clarissa; Baxter, Mark
• Is Part Of: Archives of disease in childhood. Volume 107(2022)Supplement 2
• Page Start: A23
• Page End: A24
• Publication Date: 2022-08-17
• Subjects: Children -- Diseases -- Periodicals; Infants -- Diseases -- Periodicals; 618.920005
• DOI: 10.1136/archdischild-2022-rcpch.40
• Languages: English
• ISSNs: 0003-9888

Abstract

Abstract : Aims: Trauma is the leading cause of death among young people [1 2]. The objective of this review is to outline main patterns of injury and related outcomes in this population and to describe the differences in presentations amongst younger and older adolescents within a mixed major trauma centre, with the aim of building prevention strategies for the future. Methods: Data were obtained from the trust submission to the Trauma Audit and Research Network (TARN) database. A retrospective data review was conducted of adolescents aged between 10 and 24-year-old presenting with significant injuries at University Hospital Southampton between 1/1–31/12/21. Patients with injury severity score (ISS) of 8 and above were included in the review. Results: A total of 227 records were identified, of these, 26.45% presented with major trauma (ISS>15). 177/227 (78%) of the cohort were aged 16-24 and managed by the adult trauma team while 50 (22%) were aged 10-15 years and managed by the paediatric team. Secondary transfers from trauma units accounted for 24.2% of cases. Weekly and monthly attendance trends are described in figure 1 and 2 ; These show that most patients above 16 years of age present with traumatic injuries between 22:00 and 8:00 with peaks in presentation in March and October. Between the age of 10 and 15 a daily peak was instead observed between 13:00 and 22:00. Isolated orthopaedic trauma and isolated head injuries were the most common diagnosis among the 10 to 15 age group, while polytrauma was encountered in almost 40% of presentations above 16 years of age. In the cohort examined, a total of 13 patients presented with stabbing injuries and these were mainly found in adolescents aged over 16 (84%). Mortality within 24 hours occurred in 3 patients aged respectively 11, 15 and 20. Among all patients, 19.38% where admitted in intensive care unit, with respectively 6.17% admission in paediatric intensive care and 13.21% admissions in general and neuro intensive care. Mean Inpatient stay for patients with ISS<9 was 5.5 days (±11.65) with similar figures for patients with moderate trauma (5.55 ±6.04 days), whereas, for patients with ISS>15 an average of 14.03 days (±18.23) was observed. Conclusion: It is highlighted how pattern and timing of trauma presents differences among these age groups and therefore different prevention strategies should be aimed at the two groups. Outcomes are similar in patients managed by the paediatric and the adult trauma team which demonstrates the equal effectiveness of both teams in managing these scenarios with overall comparable outcomes with national standards [3]. Differences in LOS were noted in relation to a higher ISS as expected. References: Adolescence: A period needing special attention. Health for the World's adolescents report. Geneva: World Health Organization; 2014. Cunningham RM et al. The Major Causes of Death in Children and Adolescents in the United States. N Engl J Med. 2018 Dec 20;379(25):2468-2475. doi: 10.1056/NEJMsr1804754. PMID: 30575483; PMCID: PMC6637963. Roberts Z et al, On behalf of PERUKI, et al Epidemiology of adolescent trauma in England: a review of TARN data 2008–2017 Emergency Medicine Journal 2020;37:25-30.