Objective The aims of the study were to determine key trends in trauma presentations of adolescents to the Emergency Department of a busy teaching hospital seeing 120,000 patients per year. This was to facilitate planning for a Paediatric Major Trauma Centre where this group of patients will be managed as of 2017, as well as establishing a database which will be used to inform local practice.
Method A list of all adolescent presentations was compiled by extracting data from TRAK using Business Objects. All patients between the ages of 13 and 16 (inclusive) at the date of attendance who attended the hospital’s Emergency Department/Primary Assessment Area/Surgical Observation Area between 1/2/14–31/1/15 were included. All non-traumatic presentations were excluded. The outcomes for all traumatic presentations were categorised in to; discharges, admissions and Trauma Triage Clinic follow-up. All patients requiring admission were analysed further, recording their mode of arrival, length of stay, mechanism of injury, gender, day and time of arrival and speciality admitted under. Each admission then had their Injury Severity Score calculated manually using the AIS manual and ISS calculator.
Results Admissions accounted for 2% of all adolescent trauma presentations (Figure 1). Of the 72 admissions, 65% presented outside of school hours (after 3pm) most commonly on Tuesdays, Saturdays or Sundays. 48% arrived by mode other than ambulance. 83% of admissions were male. Just 5 of the 72 admissions (7%) were classed as ‘major trauma’ with an ISS >15. These admissions correlated with a longer hospital stay, higher likelihood of ITU admission and arrival by ambulance. Mortality rate was 0, compared to 3% for adults in Scotland and 8.9% for those in the US. Only 2 patients suffered long-term sequelae as a result of their injuries.
Conclusions Overall, the study has shown that adolescent trauma is much less common and less severe than adult trauma, with better outcomes and a lower mortality rate. These key trends in adolescent trauma will help in resourcing and planning for the new Paediatric Major Trauma Centre as well as adding to the limited literature available for this group of patients.
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