Variations in injury characteristics among paediatric patients following trauma: A retrospective descriptive analysis comparing pre-hospital and in-hospital deaths at Kamuzu Central Hospital, Lilongwe, Malawi.
Malawi Medical Journal · 2017-06-01 · Observational study
Abstract
BACKGROUND: Trauma is a major cause of paediatric mortality in sub-Saharan Africa. In absence of pre-hospital care, the injury mechanism and cause of death is difficult to characterise. Injury characteristics of pre-hospital deaths (PHD) versus in-hospital deaths (IHD) were compared. METHODS: Using our trauma surveillance database, a retrospective, descriptive analysis of children (<18 years) presenting to Kamuzu Central Hospital in Lilongwe, Malawi from 2008 to 2013 was performed. Patient and injury characteristics of pre-hospital and in-hospital deaths were compared with univariate and bivariate analysis. RESULTS: Of 30,462 paediatric trauma patients presenting between 2008 and 2013, 170 and 173 were PHD and IHD, respectively. In PHD and IHD patients mean age was 7.3±4.9 v 5.2±4.3 (p<0.001), respectively. IHD patients were more likely transported via ambulance than those PHD, 51.2% v 8.3% (p<0.001). The primary mechanisms of injury for PHD were road traffic injuries (RTI) (45.8%) and drowning (22.0%), with head injury (46.7%) being the predominant cause of death. Burns were the leading mechanism of injury (61.8%) and cause of death (61.9%) in IHD, with a mean total body surface area involvement of 24.7±16.0%. CONCLUSIONS: RTI remains Malawi's major driver of paediatric mortality. A majority of these deaths attributed to head injury occur prior to hospitalisation; therefore the mortality burden is underestimated if accounting for IHD alone. Death in burn patients is likely due to under-resuscitation or sepsis. Improving pre-hospital care and head injury and burn management can improve injury related paediatric mortality.
Abstract © the authors or publisher, via PubMed. Reuse and removal
Tags
Children · Mortality & survival
Related articles
- Determining the Optimal Cutoff Value for the Reverse Shock Index Multiplied by the Glasgow Coma Scale for the Prediction of In-Hospital Mortality in Pediatric Trauma Patients: A Retrospective Cohort Study. (J Clin Med, 2025)
- Pre-hospital mortality among pediatric trauma patients in Nova Scotia. (CJEM, 2024)
- A Pediatric Application of the STRAC Regional Hospital Trauma Registry Database: Pediatric Trauma Deaths in South Central Texas During 2004-2013. (Tex Med, 2017)
- Comparing complications in pediatric trauma patients transported before and after 30 minutes. (J Pediatr Surg, 2026)
- Pediatric trauma patients in Swedish ambulance services -a retrospective observational study of assessments, interventions, and clinical outcomes. (Scand J Trauma Resusc Emerg Med, 2024)
- Validation of motor component of Glasgow coma scale in lieu of total Glasgow coma scale as a pediatric trauma field triage tool. (Am J Emerg Med, 2024)