The characteristics, pattern of injury and outcome of children admitted to a paediatric intensive care unit following an inflicted injury.

OBJECTIVE To describe the characteristics, pattern of injury and outcome of children admitted to a paediatric intensive care unit (PICU) following an inflicted injury. DESIGN, SETTING AND PARTICIPANTS A retrospective review of hospital records from a 30-bed PICU in a university teaching hospital, examining data for children admitted to the PICU after an inflicted injury from 1 January 2005 to 31 December 2013. MAIN OUTCOME MEASURES The hospital records of 46 children with an inflicted injury were reviewed. Outcome was categorised using the Pediatric Overall Performance Category score. RESULTS Sixty-one percent of children admitted to the PICU after an inflicted injury were aged under 12 months. Eighty-three percent of children required admission for a head injury. Radiological findings suggestive of pre-existing inflicted injury were evident in 50% of children. Follow-up information was available for 41 children; 76% were alive at follow-up while 24% had died. Among survivors, outcome was evaluated at a median of 11.3 months after admission to the PICU; 74% had a favourable outcome, despite 61% of these children having a disability. The remaining 26% of children had an unfavourable outcome and were likely to live dependent on care. CONCLUSIONS The majority of children admitted to intensive care following an inflicted injury are aged under 12 months. Children most commonly require intensive care for management of a head injury. Many children have radiological findings suggestive of pre-existing inflicted injury. Despite high mortality, the majority of children survive. While most are likely to be independent, many children will have residual disabilities.