Epidemiology, Risk Factors, and Surgical Outcomes of Childhood Trauma in Tertiary Care Hospitals

Abstract

Background: Childhood trauma remains one of the leading causes of morbidity and mortality worldwide. Traumatic injuries produce a spectrum of pathological changes, including fractures, traumatic brain injury, soft tissue damage, hemorrhage, and visceral organ injuries, all of which influence surgical management and outcomes. This study aimed to evaluate the epidemiological profile, risk factors, pathological patterns, and surgical outcomes of pediatric trauma patients treated at tertiary care hospitals.

Methods: A multicenter cross-sectional study was conducted among 420 children (0–18 years) presenting with traumatic injuries requiring surgical evaluation. Data on demographics, mechanism of injury, pathological findings, injury severity, surgical procedures, postoperative complications, hospital stay, and outcomes were collected. Statistical analysis was performed using SPSS version 27. Continuous variables were expressed as mean ± SD, while categorical variables were presented as frequencies and percentages. Associations were assessed using the Chi-square test and Student's t-test. Multivariate logistic regression was performed to identify independent predictors of poor surgical outcomes. A p-value <0.05 was considered statistically significant.

Results: The mean age was 8.9 ± 4.6 years, with males constituting 67.4% of patients. Road traffic accidents (38.6%), falls (34.8%), burns (15.2%), and penetrating injuries (11.4%) were the leading causes of trauma. The most common pathological findings included long-bone fractures (42.1%), soft tissue injuries (35.5%), traumatic brain injuries (21.2%), and abdominal organ injuries (13.8%). Surgical intervention was required in 61.9% of patients. Postoperative complications occurred in 14.5%, while overall mortality was 3.3%. Delayed presentation (>24 hours) (AOR 2.84; 95% CI: 1.56–5.18; p=0.001), severe injury (ISS >15) (AOR 3.72; 95% CI: 2.04–6.81; p<0.001), and polytrauma (AOR 2.39; 95% CI: 1.28–4.45; p=0.006) were independent predictors of poor surgical outcomes.

Conclusion: Childhood trauma is associated with diverse pathological injuries that significantly influence surgical outcomes. Early diagnosis, prompt surgical intervention, and timely referral substantially improve prognosis. Preventive strategies targeting road safety, fall prevention, and injury awareness are essential to reduce pediatric trauma-related morbidity and mortality.