PATTERNS AND SEVERITY OF PAEDIATRIC TRAUMA IN A TERTIARY TEACHING HOSPITAL, SOUTHERN NIGERIA

Formerly Published in Vol. 11 No. 1 Jul. - Dec., 2024

Abstract

Background: Paediatric trauma is becoming very prevalent in our environment. The extent, severity and pattern of presentation could be life threatening informing morbidity and mortality outcomes.
This study was conducted to identify patterns and severity of  paediatric trauma cases in trauma emergency room of the University of Benin Teaching Hospital, Benin City, Edo State.

Methods: A retrospective study involving 5-year records review from medical records at the Trauma Unit of the University of Benin Teaching Hospital from July 1st 2018 to September 30th, 2023. The research focused on children aged 17 years and below with trauma-related injuries. Variables collected included age, sex, ethnicity, mechanism of injury, type of injury sustained, hospitalization rate, and Glasgow Coma Score. The records were sorted for completeness with relevant data extracted in relation to study objective and entered into SPSS Version 27.0 for analysis. Bivariate analysis was computed with statistical significance set at p < 0.050.

Results: A total of 911 children with childhood trauma were identified with mean age of 3.0 ± 1.6 years. Among children identified they were predominantly males (56.2%) with Benin and Christianity (97.4%) being the predominant ethnic group and religion respectively. Most patients reported no specific illness (74.5%), while road traffic accidents (45.2%) and falls (27.1%) were the leading mechanisms of injury. Head injuries (53.8%) and fractures (32.2%) were the most common injuries. Males (p < 0.001) and clients with low GCS 3-8 (p < 0.001)  were most vulnerable and significantly affected by injury. Initial interventions focused on diagnostic imaging, with CT scans (53.2%) and X-rays (33.2%) being prominent investigation caried out. A significant proportion received fluid therapy (13.6%). Neurological impairment, assessed by the Glasgow Coma Scale, was mainly mild to moderate. A considerable number of patients were discharged within 24 hours, while 23.9% required hospitalization for 48 hours and more. Low GCS scores (p < 0.001) was significantly associated with  longer hospital stays. Overall, 63.2% of patients were hospitalized, emphasizing the need for further ongoing medical care and treatment in trauma related cases.

Conclusion:  Head injuries and fractures were the most common injuries identified with road traffic accidents and falls being the predorminant mechanism of injury over the period of review.  Males and clients with low GCS had higher level of severity to injuries, while low GCS scores was significantly associated with longer hospital stays. There is need to strengthen trauma care with focus on infrastructure, facilities, personnel while refocusing on specialized care for prevalent injuries like head trauma for prompt and effective interventions to help reduce severity and mortality rates.