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.
Original language | English |
---|---|
Article number | 6 |
Journal | World Journal of Emergency Surgery |
Volume | 18 |
Issue number | 1 |
DOIs | |
Publication status | Published - Dec 2023 |
Keywords
- Appendicitis
- Children
- Emergency
- Emergency surgery
- Injury
- Pediatric surgery
- Pediatric trauma
- Trauma surgery
- WSES
ASJC Scopus subject areas
- Surgery
- Emergency Medicine
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In: World Journal of Emergency Surgery, Vol. 18, No. 1, 6, 12.2023.
Research output: Contribution to journal › Article › peer-review
}
TY - JOUR
T1 - Pediatric trauma and emergency surgery
T2 - an international cross-sectional survey among WSES members
AU - The WSES pediatric emergency surgery collaboration group
AU - Reichert, Martin
AU - Sartelli, Massimo
AU - Askevold, Ingolf H.
AU - Braun, Jaqueline
AU - Weigand, Markus A.
AU - Hecker, Matthias
AU - Agnoletti, Vanni
AU - Coccolini, Federico
AU - Catena, Fausto
AU - Padberg, Winfried
AU - Riedel, Jens G.
AU - Hecker, Andreas
AU - Dogjani, Agron
AU - Kuriyama, Akira
AU - Porcu, Alberto
AU - Martínez-Pérez, Aleix
AU - Coppola, Alessandro
AU - Spolini, Alessandro
AU - Giordano, Alessio
AU - Kyriakidis, Alexandros
AU - Mohamedahmed, Ali Yasen Y.
AU - Vasilopoulou, Anastasia
AU - Zakaria, Andee Dzulkarnaen
AU - Balla, Andrea
AU - Fette, Andreas
AU - Litvin, Andrey
AU - Guariniello, Anna
AU - Isik, Arda
AU - Kechagias, Aristotelis
AU - Mitul, Ashrarur Rahman
AU - De Simone, Belinda
AU - Zampogna, Biagio
AU - Sensi, Bruno
AU - Gazia, Carlo
AU - Seretis, Charalampos
AU - Brooke, Cristine
AU - Luppi, Davide
AU - Coletta, Diego
AU - Sasia, Diego
AU - Corallino, Diletta
AU - Chatzipetris, Dimitrios
AU - Schizas, Dimitrios
AU - Lostoridis, Eftychios
AU - Hsabo, Elmuiz A.
AU - Kaouras, Emmanouil
AU - Schneck, Emmanuel
AU - Pinotti, Enrico
AU - Dimitrov, Evgeni
AU - D’Acapito, Fabrizio
AU - Abu-Zidan, Fikri
N1 - Funding Information: Open Access funding enabled and organized by Projekt DEAL. Martin Reichert was supported by the Justus-Liebig-University Giessen Clinician Scientist Program in Biomedical Research (JLU-CAREER) funded by the German Research Foundation (DFG No. GU405/14–1). Funding Information: The authors sincerely thank all respondents and collaborators of the study for participation in the survey. Federico Coccolini and Fausto Catena. The WSES pediatric emergency surgery collaboration group (only those who agree are listed as collaborators). Agron Dogjani, University of Medicine of Tirana, Tirana, Albania; Akira Kuriyama, Emergency and Critical Care Center, Kurashiki Central Hospital, Japan; Alberto Porcu, Università degli Studi di Sassari, Italy; Aleix Martínez-Pérez, Department of General and Digestive Surgery, Hospital Universitario Doctor Peset, Valencia, Spain; Alessandro Coppola, General Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy; Alessandro Spolini, UOC Chirurgia Generale Sondrio ASST Valtellina-Alto Lario, Italy; Alessio Giordano, General Surgery unit, Nuovo Ospedale S. Stefano, Prato, Italy; Alexandros Kyriakidis, General Hospital of Amfissa, Greece; Ali Yasen Y Mohamedahmed, Sandwell and West Birmingham NHS trust, United Kingdome; Anastasia Vasilopoulou, Trauma and Orthopedic Department, Korgialenio-Benakio- Hellenic Red Cross Hospital, Athens, Greece; Andee Dzulkarnaen Zakaria, Department of Surgery, School of Medical Sciences & Hospital USM, Universiti Sains Malaysia, Malaysia; Andrea Balla, UOC of General and Minimally Invasive Surgery, Hospital “San Paolo”, Largo Donatori del Sangue 1, Civitavecchia, Rome, Italy; Andreas Fette, PS_SS, Weissach im Tal, Germany; Andrey Litvin, Department of Surgical Disciplines, Immanuel Kant Baltic Federal University, Regional Clinical Hospital, Kaliningrad, Russia; Anna Guariniello, Santa Maria delle Croci Hospital, Ravenna, Italy; Arda Isik, Istanbul medeniyet university, Turkey; Aristotelis Kechagias, Department of General Surgery, Kanta-Häme Central Hospital, Finland; Ashrarur Rahman Mitul, Bangladesh Shishu Hospital & Institute, Bangladesh; Belinda De Simone, Department of Emergency, digestive and metabolic minimally invasive surgery, Poissy and Saint Germain en Laye Hospitals, Ile de France, France; Biagio Zampogna, Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University of Rome, Rome, Italy; Bruno Sensi, Policlinico tor vergata, Rome, Italy; Carlo Gazia, Istituto Nazionale Tumori Regina Elena, Italy; Charalampos Seretis, General University Hospital of Patras, Greece; Cristine Brooke; Davide Luppi, General And Emergency Surgery, ASMN IRCCS Reggio Emilia, Italy; Diego Coletta, AO Ospedali Riuniti Marche Nord, Department of General Surgery, Italy; Diego Sasia, General and Oncological Surgery Unit, Santa Croce and Carle Hospital, Cuneo, Italy; Diletta Corallino, Policlinico Umberto I Rome, Italy; Dimitrios Chatzipetris, Department of Surgery, Metaxa Cancer Hospital, Piraeus, Greece; Dimitrios Schizas, First Department of Surgery, Laikon General Hospital, University of Athens, Athens, Greece; Eftychios Lostoridis, Kavala General Hospital, Kavala, Greece; Elmuiz A. Hsabo, Manchester University NHS Foundation Trust, United Kingdom; Emmanouil Kaouras, Department of Surgery, Metaxa Cancer Hospital, Piraeus, Greece; Emmanuel Schneck, Department of Anesthesiology, Operative Intensive Care Medicine and Pain Therapy, University Hospital of Giessen, Rudolf-Buchheim-Strasse 7, Giessen, Germany; Enrico Pinotti, Policlinico San Pietro, Italy; Evgeni Dimitrov, Department of Surgical Diseases, University Hospital "Prof. Dr. Stoyan Kirkovich" Stara Zagora, Bulgaria; Fabrizio D’Acapito, Chirurgia Generale e Terapie ocnologiche Avanzate, Morgagni-Pierantoni Hospital, Forlì, AUSL Romagna, Italy; Federica Saraceno, UOC of General and Minimally Invasive Surgery, Hospital „San Paolo“, Largo Donatori del Sangue 1, Civitavecchia, Rome, Italy; Fikri Abu-Zidan, Department of Surgery, College of Medicine, UAE University, Al-Ain, United Arab Emirates; Francesca Maria Silvestri; Francesco Favi, U.O.C. Chirurgia Gerenale e d’Urgenza, Dipartimento Chirurgico e Grandi Traumi—Ospedale “M. Bufalini” Cesena AUSL della Romagna, Italy; Francesco Fleres, General Surgery Unit—ASST Valtellina e Alto Lario, Sondrio Hospital, Sondrio, Italy; Francesk Mulita, Department of Surgery, General University Hospital of Patras, Greece; Gabriela Nita, Sant'Anna Hospital, AUSL Reggio Emilia, Italy; Gennaro Martines, Azienda Ospedaliero Universitaria Policlinico Bari, Italy; Gennaro Mazzarella, Department of Emergency Surgery, Sapienza University of Rome, Rome, Italy; Gennaro Perrone, Department of emergency surgery, Parma Maggiore Hospital, Parma, Italy; Giorgio Giraudo, Department of Surgery ASO Santa Croce e Carle Cuneo, Italy; Giulia Bacchiocchi, Tor Vergata University, Rome, Italy; Giulio Argenio, UOC Chirurgia d'Urgenza, AOU San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy; Giuseppe Brisinda, Department of Surgery, Fondazione Policlinico Universitario A Gemelli, IRCCS and Università Cattolica S. Cuore, Rome, Italy; Giuseppe Currò, AOU Mater Domini Catanzaro—Magna Graecia University of Catanzaro, Italy; Giuseppe Palomba, Università Federico II di Napoli, Italy; Gustavo P. Fraga, Division of Trauma Surgery, School of Medical Sciences, University of Campinas (Unicamp), Brazil; Hytham K. S. Hamid, Kuwaiti Specialized Hospital, Khartoum, Sudan; Ioannis Katsaros, Department of Surgery, Metaxa Cancer Hospital, Pireaus, Greece; Ionut Negoi, General Surgery Department, Carol Davila University of Medicine and Pharmacy Bucharest, Emergency Hospital of Bucharest, Romania; Joel Noutakdie Tochie, Department of Emergency Medicine, Anaesthesiology, Critical Care Medicine, Laquintinie Hospital of Douala, Douala, Cameroon; Justin Davies, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, United Kingdom; Kenneth Y. Y. Kok, Pengiran Anak Puteri Rashidah Sa´adatul Bolkiah Institue of Health Sciences, Universiti Brunei darussalam, Brunei; Konstantinos G. Apostolou, Department of General and Endocrine Surgery, Athens Medical Center, Palaio Faliro, Athens, Greece; Konstantinos Lasithiotakis, Department of Surgery, University Hospital of Heraklion, Crete, Greece; Konstantinos Tsekouras, Sismanogleio General Hospital, Athens, Greece; Larysa Sydorchuk, Bukovinian State Medical University, Ukraine; Leandro Siragusa, Department of Surgery, Università degli studi di Roma „Tor Vergata“, Italy; Leonardo Solaini, Department of Medical and Surgical Sciences, University of Bologna, Morgagni Pierantoni Hospital, Forlì, Italy; Luca Ferrario, General Surgery Trauma Team ASST-GOM Niguarda, Milan, Italy; Luis Buonomo, Hospital Zonal de Agudos "Dr. Alberto Balestrini", Argentina; Maciej Walędziak, Military Institute of Medicine, Department of General Surgery, Poland; Mahir Gachabayov, Vladimir City Emergency Hospital, Russia; Maloni Bulanauca, Department of Surgery, Labasa Hospital, Fiji; Manish Kumar Agrawal, King George’s Medical University Lucknow, India; Marco Ceresoli, University of Milano-Bicocca, Italy; Maria Chiara Ranucci, Azienda ospedaliera Santa Maria di Terni, Italy; Maria Petridou, Department of Pediatric Surgery, Ippokration General Hospital of Thessaloniki, Thessaloniki, Greece; Mario D’Oria, Division of Vascular and Endovascular Surgery, Cardiovascular Department, University Hospital of Trieste, Italy; Massimiliano Veroux, General Surgery, University Hospital of Catania, Department of Medical and Surgical Sciences and Advanced Technologies, University of Catania, Italy; Maximos Frountzas, First Propaedeutic Department of Surgery, National and Kapodistrian University of Athens, Medical School, Hippocration General Hospital of Athens, Greece; Michel Paul Johan Teuben, Cantonal Hospital Frauenfeld, Switzerland; Miklosh Bala, Department of General Surgery, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Israel; Mirja Amadea Minger, Department of Pediatric Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; Miroslava Gonçalves, Centro Hospitalar Universitário Lisboa Norte—Hospital de Santa Maria, Lisboa, Portugal; Natasha Sharma; Nicolò Tamini, ASST Monza—Ospedale San Gerardo, Italy; Noushif Medappil, Aster Malabar Institute of Medical Sciences (Aster MIMS—Calicut), India; Orestis Ioannidis, 4th Department of Surgery, Medical School, Aristotle University of Thessaloniki, General Hospital “George Papanikolaou”, Thessaloniki, Greece; Pietro Bisagni, Department of Surgery, ASST di Lodi, Lodi, Italy; Razrim Rahim, Universiti Sains Islam Malaysia, Malaysia; Ricardo Alessandro Teixeira Gonsaga, Centro Universitário Padre Albino, Catanduva (SP), Brazil; Roberta Ragozzino, General surgery and Trauma Team, ASST Niguarda, Milano, Piazza Ospedale Maggiore 3, Milan, Italy; Roberto Bini, ASST Niguarda Hospital, Italy; Roberto Cammarata, Campus Biomedico University of Rome, Italy; Ruslan Sydorchuk, General Surgery Department, Regional Acute and Emergency Hospital Chernivtsi, Ukraine; Salomone Di Saverio, Ospedale Madonna del Soccorso San benedetto del Tronto, Italy; Selmy S. Awad, Mansoura university hospitals, Mansoura University, Egypt; Semra Demirli Atici, University of Health Sciences Tepecik Training and Research Hospital, Turkey; Serhat Meric, General surgery department, Bağcılar training and research hospital, Istanbul, Turkey; Sharfuddin Chowdhury, King Saud Medical City, Riyadh, Saudi Arabia; Sofia Xenaki, Department of General Surgery, University Hospital of Heraklion Crete, Greece; Tadeja Pintar, Surgery Department, UMC Ljubljana, Ljubljana, Sloviena; Teresa Perra, Università degli Studi di Sassari, Italy; Timothy C. Hardcastle, IALCH Trauma and UKZN Department of Surgery, Durban and University of KwaZulu-Natal, South Africa; Valerio Voglino, Ospedale Pediatrico Bambino Gesù, Roma, Italy; Varut Lohsiriwat, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand; Victor Kong, Department of Surgery, University of KwaZulu Natal, Durban, South Africa; Voskidis Christos, Pediatric Surgery, Greece; Wietse Zuidema, Amsterdam University Medical Center, Amsterdam, Netherlands. Publisher Copyright: © 2023, The Author(s).
PY - 2023/12
Y1 - 2023/12
N2 - 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.
AB - 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.
KW - Appendicitis
KW - Children
KW - Emergency
KW - Emergency surgery
KW - Injury
KW - Pediatric surgery
KW - Pediatric trauma
KW - Trauma surgery
KW - WSES
UR - http://www.scopus.com/inward/record.url?scp=85146361472&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85146361472&partnerID=8YFLogxK
U2 - 10.1186/s13017-022-00473-5
DO - 10.1186/s13017-022-00473-5
M3 - Article
C2 - 36639810
AN - SCOPUS:85146361472
SN - 1749-7922
VL - 18
JO - World Journal of Emergency Surgery
JF - World Journal of Emergency Surgery
IS - 1
M1 - 6
ER -