Retrospective analysis of pediatric road traffic accidents admitted to the emergency department of a university hospital

Aim: Road traffic accidents are common in our country, but there are not many scientific studies related to childhood road trafficaccidents. We aimed to report the frequency of road traffic accidents in children, the demographic characteristics of the patients, thephysical effects of accidents on children and their results.Material and Methods: Study data were obtained by retrospective screening of the files of pediatric cases presenting to our emergencydepartment because of road traffic accident between September 2017-2018. The cases were evaluated in terms of age, gender, typeof accidents, type of injury, radiologic imaging rates, hospitalization and mortality rates.Results: 377 cases were reviewed. 136 (36.1%) patients were female and 241 (63.9%) were male. 36.9% (n=139) of the admissionswere in summer. According to the occurrence of accidents, in-vehicle traffic accidents constituted 61.8% (n=233) of the cases.Among isolated injuries the most common site of injury was head and neck region (n=120, 31.8%). In 81.4% (n=307) of the casestomography, in 72.1% (n = 273) of cases X-ray, in 25.7% (n=96) of cases ultrasound were requested. 270 (72.2%) patients weredischarged from the emergency department with the diagnosis of soft tissue trauma. 58 (15.4%) patients were hospitalized in therespective clinics and 43 (11.4%) patients were hospitalized in the intensive care unit. It was detected that 8 patients (2.1%) died, 4of them occurred in the emergency department.Conclusion: Pediatric road traffic accidents mostly occur in the summer and most of them are in-vehicle accidents. Boys are moreexposed to road traffic accidents. Injuries in traffic accidents mostly locate in the head and neck regions followed by extremities. Itwas found that tomographic imaging was overused in our study. New strategies should be developed to reduce tomography overuse.

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1. Eliaçık K, Kılıç TY, Kanık A, ve ark. Bir eğitim araştırma hastanesi çocuk acil servisine başvuran trafik kazalarının değerlendirilmesi. Smyrna Tıp Dergisi 2013;20-3.
2. Chelly H, Bahloul M, Ammar R, et al. Clinical characteristics and prognosis of traumatic head injury following road traffic accidents admitted in ICU “analysis of 694 cases. Eur J Trauma Emerg Surg 2019;45:245-53.
3. Burstein B, Fauteux-Lamarre E, As AB. Increased morbidity associated with weekend pediatric road traffic injuries: 10-year analysis of trauma registry data. Injury 2016;47:1236-41.
4. Bucak İH, Almış H, Benli S, ve ark. Çocuk acil servisine başvuran ailelerin çocuk oto güvenlik koltuğu ve emniyet kemeri kullanımını etkileyen faktörlerin değerlendirilmesi. J Pediatr Emerg Intensive Care Med 2018;5:20-4.
5. Serinken M, Özen M. Pediyatrik yaş grubunda trafik kazası sonucu oluşan yaralanmalar ve özellikleri. Ulus Travma Acil Cerrahi Derg 2011;17:243-7.
6. Embleton DB, Ertoran İ, Önen N, ve ark. Trafik kazalarında çocukluk çağında mortalite ve morbiditenin değerlendirilmesi. Kocatepe Tıp Dergisi 2016;17:84-8.
7. Yavuz CI, Hamzaoğlu O. Road traffic-related injury among the 0-17 age group in Turkey. Ulus Travma Acil Cerrahi Derg 2011;17:318-22.
8. Hatipoğlu S. Okul öncesi çocuklarda trafik eğitiminin gerekliliği. Erişim adresi: http://www.trafik.gov.tr/ Yayınlar-Trafik Güvenliği Kongre Yayınları. Erişim tarihi: 25.03.2019
9. Berber G, Arslan MM, Karanfil R, ve ark. Diyarbakır’da kafa travmalarına bağlı çocuk ölümleri. Türkiye Klinikleri J Foren Med 2008;5:19-23.
10. Naci H, Baker TD. Productivity losses from road traffic deaths in Turkey. Int J Inj Contr Saf Promot 2008;15:19-24.
11. Durbin DR; Committee on Injury, Violence, and Poison Prevention. Child passenger safety. Pediatrics 2011;127:1050-66.
12. Sungur İ, Akdur R, Piyal B. Türkiye’deki trafik kazalarının analizi. Ankara Med J 2014;14:114-24.
13. Park GJ, Ro YS, Shin SD, et al. Preventive effects of car safety seat use on clinical outcomes in infants and young children with road traffic injuries: A 7-year observational study. Injury 2018;49:1097-103.
14. Chong SL, Tyebally A, Chew SY, et al. Road traffic injuries among children and adolescents in Singapore - Who is at greatest risk? Accident analysis and prevention Accid Anal Prev 2017;100:59-64.
15. Wang X, Yu H, Nie C, et al. Road traffic injuries in China from 2007 to 2016: the epidemiological characteristics, trends and influencing factors. PeerJ 2019;7:7423.
16. Fridman L, Fraser-Thomas J, Pike I, et al. Childhood road traffic injuries in Canada a provincial comparison of transport injury rates over time. BMC Public Health 2018;18:1348-56.
17. Tombaklar ÖH. Çocuklar ve trafik kazaları. Erişim adresi: http://www.trafik.gov.tr/ Yayınlar-Trafik Güvenliği KongreYayınları. Erişim tarihi 15.03.2019.
18. Embleton DB, User NN, Öztürk ŞN, ve ark. Çocukluk çağı araç dışı trafik kazalarının epidemiyolojisi. Kocatepe Tıp Dergisi 2018;19:7-10.
19. Sever M, Saz EU, Koşargelir M. An evaluation of the pediatric medico-legal admissions to a tertiary hospital emergency department. Ulus Travma Acil Cerrahi Derg 2010;16:260-7.
20. Çiçek Z, Koçyiğit A. Kafa travmalı çocuklarda bilgisayarlı beyin tomografisi bulguları ve maruz kalınan radyasyon. Pamukkale Üniversitesi Tıp Fakültesi Radyodiagnosik Anabilim Dalı Uzmanlık Tezi. 2012
21. Sodhi KS, Krishna S, Saxena AK, et al. Clinical application of ‘Justification’ and ‘Optimization’ principle of ALARA in pediatric CT imaging: “How many children can be protected from unnecessary radiation?”. Eur J Radiol 2015;84:1752-7.
22. Arnold M, Moore SW. Pediatric blunt abdominal trauma- are we doing too many computed tomography scans? S Afr J Surg 2013;51:26-31.
23. Cellina M, Panzeri M, Floridi C, et al. Overuse of computed tomography for minor head injury in young patients: an analysis of promoting factors. Radiol Med 2018;123:507-14.
24. Tung M, Sharma R, Hinson JS et al. Factors associated with imaging overuse in the emergency department: A systematic review. Am J Emerg Med 2018;36:301-9.
25. Di F, Gao Q, Xiang J et al. Clinical practice experiences in diagnosis and treatment of traumatic brain injury in children: a survey among clinicians at 9 large hospitals in china. PLoS One. 2015;10:0142983.