An audit of trauma-related admissions to a paediatric intensive care unit in central South Africa: 2017–2020
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Abstract
Background. Paediatric trauma is a major cause of mortality and morbidity worldwide. Policy and public health interventions have yet to adequately address paediatric trauma as a health concern in South Africa. To date, no research has documented the burden of trauma in paediatric intensive care units (PICUs) in central South Africa.
Objective. To determine the prevalence and mechanism of trauma, outcomes and use of services in children admitted to a PICU in Bloemfontein, Free State, 2017–2020.
Methods. This was a retrospective, descriptive medical record audit of trauma-related admissions to a tertiary PICU. Data collected included demographic information, mechanism of injury and outcomes (length of PICU stay, ventilator days, requirement for surgery, and death prior to discharge).
Results. Trauma-related admissions accounted for 37.7% (N=131) of available PICU bed days. Median (interquartile range) length of stay was 11 (4 - 19) days. Mechanical ventilation was required in 49 cases (37.4%), accounting for 317 ventilator days. Eight children (6.1%) died before hospital discharge. Children younger than 5 years made up 43.8% of the study sample; 65.6% were male. Road traffic accidents accounted for 51.1% of trauma cases requiring PICU admission and resulted in the highest number of surgeries, cumulative bed days and ventilator days.
Conclusion. Trauma is associated with high resource use in a tertiary PICU setting. Road traffic accidents were the main cause for admission in this study. The need to strengthen policy and infrastructure to prevent, monitor and manage childhood injuries remains an unaddressed public health concern.
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