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European Journal of Pediatrics

, Volume 165, Issue 8, pp 519–525 | Cite as

Severe outcome of children following trauma resulting from road accidents

  • Etienne Javouhey
  • Anne-Céline Guérin
  • Emmanuèle Amoros
  • Mouloud Haddak
  • Amina Ndiaye
  • Daniel Floret
  • Mireille Chiron
Original Paper

Abstract

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) ≥16] in a road accident.

Materials and 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 ≥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.

Conclusion

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.

Keywords

Outcome prediction Paediatric Registry Road accident Traumatic brain injury 

Abbreviations

AIS

Abbreviated Injury Scale

CI

Confidence interval

GCS

Glasgow Coma Score

IIS

Injury Impairment Scale

ISS

Injury Severity Score

LOS

Length Of Stay

MVO

Motor Vehicle Occupants

OR

Odds ratio

TBI

Traumatic Brain Injury

Notes

Acknowledgements

The Rhône Road Trauma Registry is funded by French Ministries for Research, for Transport (DSCR) and for Health (InVS, Inserm). The authors thank all of the staff of the ARVAC (Association du Registre des Victimes d'Accidents de la Circulation), its president, Professor V. Banssillon, and B. Laumon, who is in charge of scientific aspects of the Registry, and all those who participated in collecting and recording the data of the Registry: Ait Idir T, Ait Si Selmi T, Alloatti D, Andrillat M, Artru F, Asencio Y, Assossou I, Auzaneau F, Bagès-Limoges F, Bagou G, Balogh C, Banssillon G, Barnier N, Barth X, Basset M, Bec JF, Bejui J, Bel JC, Bérard E, Bérard J, Bernard JC, Berthet N, Bertrand JC, Besson L, Biot B, Biot V, Blanc C, Blanchard J, Bœuf C, Boisson D, Bonjean M, Bost J, Bouchedor C, Bouletreau P, Boyer V, Breda Y, Bret P, Brilland R, Bussery S, Cabet N, Caillot JL, Cannamela A, Caregnato B, Carre M, Catala Y, Chagnon PY, Chantran C, Chardon P, Charnay P, Chatelain P, Chattard S, Chavane H, Chazot G, Chettouane I, Chevreton N, Chevrillon E, Chevrillon S, Chiron M, Chotel P, Cochard P, Combe C, Contamin B, Coppard E, Cot T, Crettenet Z, Cristini A, Dal Gobbo B, De Angelis MP, Decourt L, Delfosse A, Demazière J, Deruty R, Desjardins G, Dohin B, Emonet A, Escarment J, Eyssette M, Fallavier L, Fanton L, Felten D, Feuglet P, Fifis N, Figura J, Fisher G, Fischer LP, Floccard B, Floret D, Fournier G, Fredenucci JF, Freidel M, Gadegbeku B, Galin L, Gaillard P, Gallon M, Garnier N, Garzanti A, Gaussorgues P, Gautheron V, Genevrier M, Gibaud F, Gillet Y, Goubsky A, Granger M, Grattard P, Gueniaud PY, Guenot C, Guignand M, Haddak M, Hamel D, Heckel T, Jacquemard C, Joffre T, Kohler R, Lablanche C, Lafont S, Lagier C, Lapierre B, Laplace MC, La Rosa C, Laurent R, Lebel M, Leblay G, Le-Xuan I, Lieutaud T, Lille R, Linné M, Lucas R, Machin B, Maello E, Malicier D, Mangola B, Marduel YN, Marie-Catherine M, Martin JL, Martinand G, Marty F, Messikh C, Meyer F, Meyrand S, Molard S, Morel-Chevillet E, Mioulet E, Minjaud F, Mollet C, Monnet J, Moreno S, Moyen B, Ndiaye A, Neidhart JP, Ngandu E, Ny S, Ould T, Paget P, Paillot JC, Paris D, Patay B, Pauget P, Peillon D, Perrin-Blondeau D, Petit P, Piton JL, Plantier M, Pornon P, Pramayon C, Quelard B, Rezig M, Rigal F, Robert D, Rode G, Romanet JP, Rongieras F, Roset C, Rousson A, Roussouli P, Roux H, Ruhl C, Salamand J, Sametzky P, Sayegh K, Sbraire N, Scappaticci N, Schiele P, Schneider M, Simonet C, Sindou M, Soldner R, Soudain M, Stagnara J, Stamm D, Suc B, Taesch MC, Tasseau F, Tell L, Thomas M, Tilhet-Coartet S, Toukou JC, Trifot M, Vallet G, Vancuyck A, Vergnes I, Verney MP, Voiglio EJ, Vourey G, Vuillard J, Westphal M, Willemen L.

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Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  • Etienne Javouhey
    • 1
    • 2
  • Anne-Céline Guérin
    • 1
  • Emmanuèle Amoros
    • 1
  • Mouloud Haddak
    • 1
  • Amina Ndiaye
    • 1
  • Daniel Floret
    • 1
    • 2
  • Mireille Chiron
    • 1
  1. 1.UMRESTTE (Epidemiological Research and Surveillance Unit in Transport, Occupation and Environment), Joint Unit of Inrets (French National Institute for Transport and Safety Research)University Claude-Bernard Lyon 1, and InVS (National Institute for Public Health Surveillance)BronFrance
  2. 2.Pediatric Intensive Care UnitEdouard Herriot Hospital, Hospices Civils de LyonLyon Cedex 03France

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