Forthcoming Issue Vol. 19 no. 2 An audit of children with injuries presenting to a tertiary paediatric intensive care unit in central South Africa: 2017–2020
Article Sidebar
Main Article Content
Abstract
Background. Injuries remain an important cause of child mortality and morbidity. Policy and public health interventions have yet to adequately address childhood injuries as a key health concern in South Africa. To date, no research has documented the burden of childhood injuries in paediatric intensive care units (PICUs) in central South Africa. Where PICU resources are constrained, it is necessary to assess the role of injuries.
Objectives. This study aimed to determine the prevalence and mechanism of injuries, outcomes, and usage of PICU services in children admitted to a PICU in Bloemfontein, Free State, 2017–2020.
Methods. Retrospective, descriptive medical record audit.
Results. During the study period, 131 children were admitted with injuries to the PICU. Trauma-related admissions accounted for 37.7% of available PICU bed days. Median PICU length of stay was 11 days (IQR 4–19). Mechanical ventilation was required in 49 (37.4%) children, accounting for 317 ventilator days. Eight children (6.1%) died before hospital discharge. Children younger than 5 years comprised 43.8% of the study population, and 65.6% were male. Road traffic accidents comprised 51.1% of injuries requiring PICU admission and necessitated the highest number of surgeries, cumulative bed days and ventilator days.
Conclusion. Injuries are an important contributor to burden of disease and resource use in a tertiary PICU in central South Africa. Road traffic accidents were the main contributor in this study population. The need to strengthen policy and infrastructure to prevent, monitor and manage childhood injuries remains an important and yet unaddressed public health concern.
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
The SAJCH is published under an Attribution-Non Commercial International Creative Commons Attribution (CC-BY-NC 4.0) License. Under this license, authors agree to make articles available to users, without permission or fees, for any lawful, non-commercial purpose. Users may read, copy, or re-use published content as long as the author and original place of publication are properly cited.
Exceptions to this license model is allowed for UKRI and research funded by organisations requiring that research be published open-access without embargo, under a CC-BY licence. As per the journals archiving policy, authors are permitted to self-archive the author-accepted manuscript (AAM) in a repository.
How to Cite
References
Peden M, World Health Organization. World report on child injury prevention. Geneva: World Health Organization, 2008. https://iris.who.int/handle/10665/43851 (accessed 30 April 2024).
Matzopoulos R, Prinsloo M, Pillay-van Wyk V, et al. Injury-related mortality in South Africa: a retrospective descriptive study of postmortem investigations. Bull World Health Organ 2015;93(5):303-313. https://doi.org/10.2471/BLT.14.145771
Mathews S, Martin LJ, Coetzee D, et al. The South African child death review pilot: a multiagency approach to strengthen healthcare and protection for children. S Afr Med J 2016;106(9):895-899. https://doi.org/10.7196/SAMJ.2016.v106i9.11234
Prinsloo M, Hunter K, Matzopoulos R, et al. Non-fatal injuries among boys and girls presenting to Red Cross War Memorial Children’s Hospital, Cape Town, South Africa. S Afr Med J 2022;112(7):465-471. https://doi.org/10.7196/SAMJ.2022.v112i7.16303
Van As AB, Millar AJ. From the pursuit of excellence to the quest for significance: promotion of a Childsafe South Africa. S Afr Med J 2012;102(6):427-428. https://doi.org/10.7196/samj.5602
Herbert HK, van As AB, Bachani AM, et al. Patterns of pediatric injury in South Africa: an analysis of hospital data between 1997 and 2006. J Trauma Acute Care Surg 2012;73(1):168-174. https://doi.org/10.1097/TA.0b013e31824d67c3
Bhagwanjee S, Scribante J. National audit of critical care resources in South Africa - unit and bed distribution. S Afr Med J 2007;97(12 Pt 3):1311-1314.
Scribante J, Bhagwanjee S. National audit of critical care resources in South Africa - nursing profile. S Afr Med J 2007;97(12 Pt 3):1315-1318.
Argent AC, Ahrens J, Morrow BM, et al. Pediatric intensive care in South Africa: an account of making optimum use of limited resources at the Red Cross War Memorial Children’s Hospital. Pediatr Crit Care Med 2014;15(1):7-14. https://doi.org/10.1097/PCC.0000000000000029
Clarence E, Jeena PM. The unmet need for critical care at a quaternary paediatric intensive care unit in South Africa. S Afr Med J 2022;112(11):871-878. https://doi.org/10.7196/SAMJ.2022.v112i11.16452
Msemburi W, Pillay-van Wyk V, Dorrington R, et al. Second national burden of disease study for South Africa: cause-of-death profile for South Africa, 1997–2012. Cape Town: South African Medical Research Council, 2016. https://www.samrc.ac.za/sites/default/files/attachments/2022-08/SouthAfrica2012.pdf (accessed 30 April 2024).
Patel N, Khofi-Phiri I, Mathiva LR, Grieve A, Loveland J, Nethathe GD. Trauma related admissions to the PICU at Chris Hani Baragwanath Academic Hospital, Johannesburg. Pediatr Surg Int 2017;33(9):1013-1018. https://doi.org/10.1007/s00383-017-4125-0
Mashavave NZ, Withers A, Doedens L, Jugmohan B, Loveland J. A retrospective study analysing mortality and outcomes in the paediatric burns intensive care unit at the Chris Hani Baragwanath Academic Hospital, Johannesburg. S Afr J Child Health 2020;14(4):212-216. https://doi.org/10.7196/SAJCH.2020.v14i4.1724
Hodkinson P, Argent A, Wallis L, et al. Pathways to care for critically ill or injured children: a cohort study from first presentation to healthcare services through to admission to intensive care or death. PLoS One 2016;11(1):e0145473. https://doi.org/10.1371/journal.pone.0145473