THE CHILD WITH MULTIPLE INJURIES - A RETROSPECTIVE COMPARISON BETWEENCHILDREN, TEENAGERS AND ADULTS WITH MULTIPLE INJURIES

Numerous epidemiological studies about multiple trauma patients do not include an analysis of patients under the age of 18. To study this, t he data of 682 patients with multiple traumata, treated between 1981 a nd 1991 at Hannover Medical School, Germany, were retrospectively anal yzed. The patients were divided into four age-related groups: preschoo l age (< 6 years), school age (< 13 years), teenagers (< 18 years) and adults (greater than or equal to 18 years). Analyzed were the cause o f trauma, localization of injuries and the cause of death. Children we re less often injured as passengers in cars, but more often injured as pedestrians and bicyclists than adults. However, children showed a si gnificant higher mortality than adults, with threefold increased risk of death when they injured as passengers in car accidents. In all grou ps injuries to the head and the legs were most common. Children showed a lower incidence of trauma to the thorax, abdomen, hip and arms than the adult group. Nevertheless, trauma to the thorax, abdomen and head was associated with the highest risk of death in all groups. Spinal c ord injuries, especially injuries to the neck, also showed a high risk of death. Children younger than 6 years had the most severe head inju ries. Safety improvements for children in cars, helmet usage on bicycl es and early training in traffic safety for children might decrease th e lethality in this group of trauma patients.