Multiple trauma in children: predicting outcome and long-term results.
OBJECTIVE
To analyze the management of pediatric trauma and the efficacy of the Pediatric Trauma Score (PTS) in classifying injury severity and predicting prognosis.


METHODS
A retrospective case series.


METHODS
The Children's Hospital of Eastern Ontario, a major pediatric trauma centre.


METHODS
One hundred and forty-nine traumatized children with 2 or more injuries to 1 body system or a single injury to 2 or more body systems.


METHODS
Use of the PTS and Glasgow Coma Scale score in trauma management.


METHODS
Types of injuries sustained, complications, missed injuries, psychosocial effects and residual deficiencies.


RESULTS
The average PTS was 8.5 (range from -3 to 11). The total number of injuries sustained was 494, most commonly closed head injury (86). Forty-two percent of children with an average trauma score of 8.5 were treated surgically. There were 13 missed injuries, and complications were encountered in 57 children, the most common being secondary to fractures. Forty-eight (32%) children had residual long-term deficiency, most commonly neurologic deficiency secondary to head injury.


CONCLUSIONS
Fractures should be stabilized early to decrease long-term complications. A deficiency of the PTS is the weighting of open fractures of a minor bone. For example, metacarpal fracture is given the same weight as an open fracture of the femur. Neuropsychologic difficulties secondary to trauma are a major sequela of trauma in children.
Letts
Mervyn
M
Division of Orthopaedics, Children's Hospital of Eastern Ontario, University of Ottawa.
Davidson
Darin
D
Lapner
Peter
P
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D015601:Injury Severity Score; D008297:Male; D009104:Multiple Trauma / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome