Objective: To describe paediatric major trauma presenting to a tertiary major adult and paediatric trauma centre in an outer regional locality in Australia.
Methods: A retrospective review of paediatric (age <16) major trauma (ISS > 12 or death) was conducted using data from the local Trauma Service Database from January 2021 to December 2023.
Setting: Single Centre, Townsville University Hospital, Australia
Results: Of the 76 patients, most were male (68%), sustained blunt trauma (93%), with a median injury severity score (ISS) of 17 (IQR 16-22). A high proportion were Indigenous Australians (30%), transferred in from other hospitals (61%), and were admitted to the Paediatric Intensive Care Unit (71%). Cause of injury were most commonly categorised as motorcycle (18%), low fall (17%) motor vehicle (16%) and pedestrian (13%). Major trauma cases varied from 17 to 37 per year. Only 4 patients (5.3%) were transferred to another hospital for acute care and average hospital length of stay (LOS) was 10.5 days. The case fatality rate was 13%. Of all paediatric deaths, a high proportion were pedestrians (40%), suffered a Traumatic Brain Injury (60%), with majority (60%) aged 0-4.
Conclusions: This study highlights the unique characteristics of paediatric major trauma presenting to this regional major trauma centre and resourcing utilised. Injury prevention efforts need to be tailored to the population, considering cultural sensitivity and regional causes of injury, including paediatric motorcycle use. Ongoing investment for prevention efforts and paediatric trauma system development is needed. Due to low numbers, case fatality rate should be interpreted cautiously.