| Abstract |
Background: Accidents represent the leading cause of significant morbidity and mortality in
children worldwide, constituting an important and intractable public health problem.
Depending on their severity, they can cause irreversible damage and have a number of
different consequences with potentially significant effects on the lives of both children and
their families, reflecting aspects of their quality of life, their neurodevelopment, but also their
physical health and their integrity. The long-term consequences may be related to cognitive,
emotional, behavioral and/or social domains, with an impact on the family and society, with
the corresponding costs.
Objective: Is the recording of epidemiological data for children hospitalized in a University
Children's ICU after a serious accident and the correlation of the severity of the accident with
indicators of outcome and quality of life after their discharge from the ICU.
Methods: This is a retrospective study of patients admitted to the PAGNI Children's Intensive
Care Unit for the years 2014-2022. The study included children aged >30 days to <18 years
who were admitted to the Children's ICU after a serious accident. Demographic and clinical
data, disease/injury severity scales and outcome indicators were studied, as well as their long-
term outcome with the Pediatric Quality of Life Inventory TM 4.0 Generic Core Scale
(PedsQoL).
Results: Of the 1264 patients hospitalized in the PICU during the study period, 222 (17.5%)
had an accident as the reason for admission, and finally 162 pediatric patients participated
(male 106 (65.4%), mean age 7.4±5.7). The types of accidents were traffic (passenger or
pedestrian) (25.2%), drowning-foreign body (19.8%), falls and multiple injuries (27.2%),
drowning in a body of water (9.3%), burns-electric shock (12.3%), poisonings (6.2%). 62
(38.3%) children needed surgery, 109 (67.3%) were put on mechanical ventilation, the
duration of hospitalization was 8.8±11 days and 10 (6.2%) died. The number of ICU admissions
remained stable over time, as did the mechanism of the accident. Age was significantly
associated with the mechanism of injury (p<0.001) and with the site of the event (p<0.001).
Low level of consciousness (GCS) on admission and trauma severity (PTS) were inversely
related to length of stay in the ICU (all p<0.001). Patients who died had higher clinical severity
scores (PRISM-II and PELOD, p<0.001), longer duration of mechanical ventilation (p<0.001)
and duration of hospitalization in the pediatric ICU (p<0.001). Mortality was more frequent in
those who drowned in water and in those with multiple injuries (p=0.036). In terms of long-
term outcome, 3 (1.9%) patients were transferred to a rehabilitation center and 4 (2.5%) [18]
patients had permanent disability. Physical and psychosocial health did not differ between
age groups, while physical health differed from psychosocial health in the 5-7 age group
(p=0.007).
Conclusion: Most of the children were preschoolers and boys. Drowning, suffocation and
burns were the leading causes of injury at young ages, while traffic accidents, falls and
poisoning were leading causes of injury at older ages. Children who died were more often
multi-traumatized or after drowning in a water feature, had a lower level of consciousness,
greater injury severity, and longer duration of mechanical ventilation and hospitalization in
the pediatric ICU. The majority of victims survived and they had a very good psychosomatic
development with low rates of mortality and disability.
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Επιδημιολογία ατυχημάτων και διερεύνηση παραγόντων κινδύνου και έκβασης παιδιών και εφήβων που νοσηλεύτηκαν σε ΜΕΘ
