Severe outcome of children following trauma resulting from road accidents.
OBJECTIVE
The aim of the study was to determine the risk factors of a severe outcome for children severely injured [killed or with an Injury Severity Score (ISS)>or=16] in a road accident.


METHODS
Casualties that occurred between 1996 and 2001 which involved children under 14 years of age were assessed in a population-based study based on data included in a French road trauma Registry. A severe traumatic brain injury (TBI) was defined as a head injury with an Abbreviated Injury Scale (AIS) severity score>or=3. A multivariate logistic regression was performed to quantify the risk of a "severe outcome" defined as death or an expected serious impairment 1 year later.


RESULTS
The annual incidence of an ISS of 16+ was 7.7 per 100,000 children. Among the 126 severely injured children included in this study, 40 died (including 16 immediate deaths), and a severe outcome was expected for 54 of the 86 survivors. Children with an "isolated severe TBI" and those with "multiple injuries including TBI" were more likely to have a severe outcome than those who had an "isolated severe injury without TBI" (OR: 7.91; 95%CI: 1.43-43.77 and OR: 8.37; 95%CI: 1.52-46.13, respectively). Age was inversely linked to a severe outcome. The unprotected motor vehicle occupants (MVO) had an odds ratio of 7.56 (95%CI: 1.07-53.56) compared to the protected MVO. Only 30% of children who survived a severe TBI were admitted to rehabilitation.


CONCLUSIONS
The mechanism of the injury, an injury pattern involving the head and a young age were associated with a severe outcome following a road accident. A majority of children severely injured were not referred to inpatient rehabilitation.
Javouhey
Etienne
E
UMRESTTE, Joint Unit of Inrets, University Claude-Bernard Lyon 1, and InVS, Bron, and Pediatric Intensive Care Unit, Edouard Herriot Hospital, Lyon, France. etienne.javouhey@chu-lyon.fr
Guérin
Anne-Céline
AC
Amoros
Emmanuèle
E
Haddak
Mouloud
M
Ndiaye
Amina
A
Floret
Daniel
D
Chiron
Mireille
M
D015998:Abbreviated Injury Scale; D000063:Accidents, Traffic / Q000401:mortality / Q000706:statistics & numerical data*; D000293:Adolescent; D017677:Age Distribution; D000367:Age Factors; D001930:Brain Injuries / Q000453:epidemiology / Q000534:rehabilitation; D002648:Child; D002675:Child, Preschool; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D015601:Injury Severity Score; D007902:Length of Stay / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D012042:Registries; D012307:Risk Factors; D012622:Seat Belts; D017678:Sex Distribution; D013898:Thoracic Injuries / Q000453:epidemiology