@article{ref1, title="Increased mortality rates of young children with traumatic injuries at a US army combat support hospital in Baghdad, Iraq, 2004", journal="Pediatrics", year="2008", author="Matos, Renee I. and Holcomb, John B. and Callahan, Catina and Spinella, Philip C.", volume="122", number="5", pages="e959-66", abstract="OBJECTIVE: The objective of this study was to determine whether age <or=8 y is an independent predictor of mortality in noncoalition trauma patients at a US combat support hospital. METHODS: A retrospective chart review was conducted of 1132 noncoalition trauma patients who were admitted to a combat support hospital between December 2003 and December 2004. Data on age, severity of injury indices, and in-hospital mortality rates were analyzed. All variables that were associated with death on univariate analysis were analyzed by multivariate logistic regression to determine independent associations with mortality. RESULTS: There were 38 young pediatric patients (aged <or=8 years) and 1094 older pediatric and adult patients (aged >8 years). Penetrating trauma accounted for 83% of all injuries. Young pediatric patients compared with older pediatric and adult patients had increased severity of injury indicated by decreased Glasgow Coma Scale score; increased incidence of hypotension, base deficit, and serum pH on admission; red blood cell transfusion amount; and increased injury severity scores on admission. Young pediatric patients compared with older pediatric and adult patients also had increased ICU lengths of stay (median 2 [interquartile range 0-5] vs median 0 [interquartile range 0-2] days) and in-hospital mortality rate (18% vs 4%), respectively. Multivariate logistic regression indicated that base deficit, injury severity score of >or=15, Glasgow Coma Scale score of <or=8, and age of <or= 8 years were independently associated with mortality. CONCLUSIONS: Young children who present to a combat support hospital have increased severity of injury compared with older children and adults. In a population with primarily penetrating injuries, after adjustment for severity of injury, young children may also have an independent increased risk for death compared with older children and adults. Providing forward-deployed medical staff with pediatric-specific equipment and training in the acute care of young children with severe traumaticinjuriesmay improve outcomes in this population.

Language: en

", language="en", issn="0031-4005", doi="10.1542/peds.2008-1244", url="http://dx.doi.org/10.1542/peds.2008-1244" }