Understanding non-accidental trauma in the United States: A national trauma databank study.
J Pediatr Surg
; 55(4): 693-697, 2020 Apr.
Article
en En
| MEDLINE
| ID: mdl-31103270
ABSTRACT
BACKGROUND:
The purpose of this study is to characterize the epidemiology, injury patterns, outcomes and trends of non-accidental trauma (NAT) in the United States using a large national database.METHODS:
Children <15 years presenting after NAT were identified in the 2007-2014 National Trauma Databank research datasets. Clinical and outcome data were analyzed using descriptive statistics, chi-square and logistic regression.RESULTS:
Of 678,503 children admitted for traumatic injuries, 3% (19,149) were victims of NAT. The majority (95%) were under 5 years and 71% under 1 year old. The majority (59%) were male. The median injury severity score (ISS) was 10 (IQR5-19). African Americans were disproportionally affected (27% vs 17% of all traumas), and the majority had public or no insurance (85%). Incidence was highest in the midwest and lowest in the northeast regions of the country, although trends varied over time. NAT resulted in 43% of trauma deaths in children <1 year and 31% of trauma deaths in children <5. Traumatic brain injury (TBI) was the most commonly encountered diagnosis (50%). Polytrauma was common, and certain injury patterns were identified. Urgent operation was required in 6%, 43% were admitted to intensive care, and 9% died. Mortality was independently associated with TBI, thoracic injury, hollow viscus injury and older age.CONCLUSION:
Non-accidental trauma is a leading cause of trauma mortality in young children. Multiple injuries are common, requiring comprehensive evaluation and early surgical involvement. The data presented in this study could serve as a guide to target injury prevention efforts. LEVEL OF EVIDENCE III STUDY TYPE Prognostic and Epidemiological.Palabras clave
Texto completo:
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Banco de datos:
MEDLINE
Asunto principal:
Centros Traumatológicos
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Traumatismo Múltiple
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Maltrato a los Niños
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Abuso Físico
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Lesiones Traumáticas del Encéfalo
Tipo de estudio:
Etiology_studies
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Incidence_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Adolescent
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Adult
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Child
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Child, preschool
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Female
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Humans
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Infant
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Male
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Newborn
País/Región como asunto:
America do norte
Idioma:
En
Revista:
J Pediatr Surg
Año:
2020
Tipo del documento:
Article