Background: In contrast to adults, the situation for pediatric trauma care from an international point of view and the global management of severely injured children remain rather unclear. The current study investigates structural management of pediatric trauma in centers of different trauma levels as well as experiences with pediatric trauma management around the world. Methods: A web-survey had been distributed to the global mailing list of the World Society of Emergency Surgery from 10/2021-03/2022, investigating characteristics of respondents and affiliated hospitals, case-load of pediatric trauma patients, capacities and infrastructure for critical care in children, trauma team composition, clinical work-up and individual experiences with pediatric trauma management in response to patients´ age. The collaboration group was subdivided regarding sizes of affiliated hospitals to allow comparisons concerning hospital volumes. Comparable results were conducted to statistical analysis. Results: A total of 133 participants from 34 countries, i.e. 5 continents responded to the survey. They were most commonly affiliated with larger hospitals (> 500 beds in 72.9%) and with level I or II trauma centers (82.0%), respectively. 74.4% of hospitals offer unrestricted pediatric medical care, but only 63.2% and 42.9% of the participants had sufficient experiences with trauma care in children ≤ 10 and ≤ 5 years of age (p = 0.0014). This situation is aggravated in participants from smaller hospitals (p < 0.01). With regard to hospital size (≤ 500 versus > 500 in-hospital beds), larger hospitals were more likely affiliated with advanced trauma centers, more elaborated pediatric intensive care infrastructure (p < 0.0001), treated children at all ages more frequently (p = 0.0938) and have higher case-loads of severely injured children < 12 years of age (p = 0.0009). Therefore, the majority of larger hospitals reserve either pediatric surgery departments or board-certified pediatric surgeons (p < 0.0001) and in-hospital trauma management is conducted more multi-disciplinarily. However, the majority of respondents does not feel prepared for treatment of severe pediatric trauma and call for special educational and practical training courses (overall: 80.2% and 64.3%, respectively). Conclusions: Multi-professional management of pediatric trauma and individual experiences with severely injured children depend on volumes, level of trauma centers and infrastructure of the hospital. However, respondents from hospitals at all levels of trauma care complain about an alarming lack of knowledge on pediatric trauma management.
Pediatric trauma and emergency surgery: an international cross-sectional survey among WSES members / Reichert, Martin; Sartelli, Massimo; Askevold, Ingolf H; Braun, Jaqueline; Weigand, Markus A; Hecker, Matthias; Agnoletti, Vanni; Coccolini, Federico; Catena, Fausto; Padberg, Winfried; Riedel, Jens G; Hecker, Andreas; Agron Dogjani, Akira Kuriyama, Alberto Porcu, Aleix Martínez-Pérez, Alessandro Coppola, Alessandro Spolini, Alessio Giordano, Alexandros Kyriakidis, Ali Yasen Y Mohamedahmed, Anastasia Vasilopoulou, Andee Dzulkarnaen Zakaria, Andrea Balla, Andreas Fette, Andrey Litvin, Anna Guariniello, Arda Isik, Aristotelis Kechagias, Ashrarur Rahman Mitul, Belinda De Simone, Biagio Zampogna, Bruno Sensi, Carlo Gazia, Charalampos Seretis, Cristine Brooke, Davide Luppi, Diego Coletta, Diego Sasia, Diletta Corallino, Dimitrios Chatzipetris, Dimitrios Schizas, Eftychios Lostoridis, Elmuiz A Hsabo, Emmanouil Kaouras, Emmanuel Schneck, Enrico Pinotti, Evgeni Dimitrov, Fabrizio D'Acapito, Federica Saraceno, Fikri Abu-Zidan, Francesca Maria Silvestri, Francesco Favi, Francesco Fleres, Francesk Mulita, Gabriela Nita, Gennaro Martines, Gennaro Mazzarella, Gennaro Perrone, Giorgio Giraudo, Giulia Bacchiocchi, Giulio Argenio, Giuseppe Brisinda, Giuseppe Currò, Giuseppe Palomba, Gustavo P Fraga, Hytham K S Hamid, Ioannis Katsaros, Ionut Negoi, Joel Noutakdie Tochie, Justin Davies, Kenneth Y Y Kok, Konstantinos G Apostolou, Konstantinos Lasithiotakis, Konstantinos Tsekouras, Larysa Sydorchuk, Leandro Siragusa, Leonardo Solaini, Luca Ferrario, Luis Buonomo, Maciej Walędziak, Mahir Gachabayov, Maloni Bulanauca, Manish Kumar Agrawal, Marco Ceresoli, Maria Chiara Ranucci, Maria Petridou, Mario D'Oria, Massimiliano Veroux, Maximos Frountzas, Michel Paul Johan Teuben, Miklosh Bala, Mirja Amadea Minger, Miroslava Gonçalves, Natasha Sharma, Nicolò Tamini, Noushif Medappil, Orestis Ioannidis, Pietro Bisagni, Razrim Rahim, Ricardo Alessandro Teixeira Gonsaga, Roberta Ragozzino, Roberto Bini, Roberto Cammarata, Ruslan Sydorchuk, Salomone Di Saverio, Selmy S Awad, Semra Demirli Atici, Serhat Meric, Sharfuddin Chowdhury, Sofia Xenaki, Tadeja Pintar, Teresa Perra, Timothy C Hardcastle, Valerio Voglino, Varut Lohsiriwat, Victor Kong, Voskidis Christos, Wietse Zuidema. - In: WORLD JOURNAL OF EMERGENCY SURGERY. - ISSN 1749-7922. - ELETTRONICO. - 18:1(2023), pp. 6.1-6.14. [10.1186/s13017-022-00473-5]
Pediatric trauma and emergency surgery: an international cross-sectional survey among WSES members
Agnoletti, Vanni;Leonardo Solaini;
2023
Abstract
Background: In contrast to adults, the situation for pediatric trauma care from an international point of view and the global management of severely injured children remain rather unclear. The current study investigates structural management of pediatric trauma in centers of different trauma levels as well as experiences with pediatric trauma management around the world. Methods: A web-survey had been distributed to the global mailing list of the World Society of Emergency Surgery from 10/2021-03/2022, investigating characteristics of respondents and affiliated hospitals, case-load of pediatric trauma patients, capacities and infrastructure for critical care in children, trauma team composition, clinical work-up and individual experiences with pediatric trauma management in response to patients´ age. The collaboration group was subdivided regarding sizes of affiliated hospitals to allow comparisons concerning hospital volumes. Comparable results were conducted to statistical analysis. Results: A total of 133 participants from 34 countries, i.e. 5 continents responded to the survey. They were most commonly affiliated with larger hospitals (> 500 beds in 72.9%) and with level I or II trauma centers (82.0%), respectively. 74.4% of hospitals offer unrestricted pediatric medical care, but only 63.2% and 42.9% of the participants had sufficient experiences with trauma care in children ≤ 10 and ≤ 5 years of age (p = 0.0014). This situation is aggravated in participants from smaller hospitals (p < 0.01). With regard to hospital size (≤ 500 versus > 500 in-hospital beds), larger hospitals were more likely affiliated with advanced trauma centers, more elaborated pediatric intensive care infrastructure (p < 0.0001), treated children at all ages more frequently (p = 0.0938) and have higher case-loads of severely injured children < 12 years of age (p = 0.0009). Therefore, the majority of larger hospitals reserve either pediatric surgery departments or board-certified pediatric surgeons (p < 0.0001) and in-hospital trauma management is conducted more multi-disciplinarily. However, the majority of respondents does not feel prepared for treatment of severe pediatric trauma and call for special educational and practical training courses (overall: 80.2% and 64.3%, respectively). Conclusions: Multi-professional management of pediatric trauma and individual experiences with severely injured children depend on volumes, level of trauma centers and infrastructure of the hospital. However, respondents from hospitals at all levels of trauma care complain about an alarming lack of knowledge on pediatric trauma management.| File | Dimensione | Formato | |
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