Retrospective review of paediatrics patients involved in pedestrian vehicle accidents in greater cape Town

• Main Author: Moller, Izelle
• Other Authors: Liebenberg, Linda
• Format: Dissertation
• Language: English
• Published: Faculty of Health Sciences 2021
• Subjects: Forensic Pathology
• Online Access: http://hdl.handle.net/11427/32860

Pedestrian vehicle injuries are a growing public health threat worldwide. In South Africa, pedestrian accidents are the leading cause of injury related deaths in children younger than 15 years. There is international and national research looking at various aspects of pedestrian vehicle accidents. Previous studies have highlighted the general distribution of injuries sustained in paediatric pedestrian accidents. However, the specific types of injuries sustained by children pedestrians in different age groups have not been widely researched. We conducted a retrospective review of children involved in road traffic accidents as pedestrians in the greater Cape Town area from 2011 to 2015. The study population included patients below the age of 13 years that were admitted to Red Cross Children's Hospital (RCCH), as well as those subjects that died and presented to the Forensic Pathology Laboratory in Salt River also known as Salt River Mortuary (SRM). The age group 0-12 years was selected because RCCH is a referral paediatric hospital that only admits children under the age of 13 years. Data obtained from the study population were analysed according to age, gender, time, date (day of week and month) and area of accident, as well as injuries sustained. Cases were grouped according to age in order to analyse and compare changes in injury patterns for different groups. Age groups 0-4 years, 5-9 years and 10-12 years were selected. Further comparison of the injuries sustained was made between children admitted to RCCH (survivors) and subjects admitted to SRM (deceased). During the 5-year period 552 children were admitted to RCCH and 109 cases were admitted to SRM with 2:1 male to female predominance in both study groups. In our study, the group with the highest number/percentage of deaths was children aged 0 – 4 years, which contrasts with previous research. Most of the accidents (75-80%) occurred in lower socioeconomic areas. Significantly more head injuries occurred in children who died from their injuries than those who survived (96% versus 18%) (p < 0.0001). Out of the children who demised, 27% had spinal injuries, 61% had chest injuries and 43% had abdominal injuries, all of which were significantly higher than children who survived (p < 0.0001 for each). Upper limb injuries were equal between the two groups (12% vs 13%) and lower limb injuries were more common in the survivors (46% vs 24%). These results are the first to be documented in Cape Town and provide insight into the nature of injuries sustained by children involved in pedestrian vehicle accidents.