소아 다발성 외상 환자의 중증도에 영향을 주는 요인 분석

Abstract

Background : The purpose of this study is, first, analyze the risk factors that influence the severity of pediatric multiple trauma patients and, second, present solutions for the problems related with them. Our living situations are so much complicated that the danger of accidents is truly open to children without any preparation. We need to get interested in the increase of various accidents for children.

Method : The object of this study is the patients who visited the emergency medical center in Chosun university hospital from January 1, 2006 to December 31, 2008. We evaluated the general characteristics : mechanism of injury, vital sign, Revised Trauma Score(RTS), Injury Severity Score(ISS), Hemoglobin Value which was checked at visiting time, and presence or absence of emergent and regular operation, based on medical record. We divided the levels as follows: light level(1-8 points), mid level(9-15 points), and serious level(above 18 points). We analyzed the medical data by using SPSS 17.0 for window.

Result: The average age of patients examined was 8.6 years. The number of 6-11 aged patients was 96, which was the largest, but the degree of severity is the highest at infant period(0-2 years), marking 7.95(± 6.85). While the frequency of the accident is the highest at sunny days. The accidential time is the most from 16:00 to 20:00. The cause of multiple trauma for children was the greatest in the traffic accident, marking 95 persons (49.0%). In addition, the cause by traffic accident showed the highest ISS value(9.02± 6.42) and the most serious degree (P=0.004) as well. The value of injury (8.40 ± 6.64) at the case that the patients was moved from secondary hospital was higher than that of case(6.49± 5.57) that the patients visited directly. The severity of it is the highest at the case that patients used a 119 ambulance(8.84± 5.80). According to the injured parts of body, the injure of arms and feet is the highest (79 persons, 40.7%), but the value of injury is the highest at internal organs and chest, marking 16.42± 8.56 and 11.23± 6.97 respectively.

Conclusion : We used Abbreviated Injury Scale: AIS) in order to examine characteristics by injured body part from pediatric multiple trauma patients. Because the degree of injury was the highest at internal organs or chest, we need to more seriously examine and care the patients who was suspicioned with the injury of internal organs or chest. We need to quickly determine the possibility of operation toward the patients seriously injured at arms and feet which is the greatest at the frequency. In particular, we need to consider the operational cure of patients who are not very high at the severity of injury at their brains.

Key words : Multiple, Trauma, Severity