Children admitted to Paediatric Intensive Care at Red Cross War Memorial Children?s Hospital with Non-Accidental injuries (2012-2020): a retrospective descriptive study

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dc.contributor.advisorMorrow, Brenda
dc.contributor.advisorRossouw Beyra
dc.contributor.authorBowes, Lynelle
dc.date.accessioned2025-06-25T13:18:59Z
dc.date.available2025-06-25T13:18:59Z
dc.date.issued2025
dc.date.updated2025-06-25T13:14:56Z
dc.description.abstractObjectives: To describe the characteristics and outcomes of patients admitted to the paediatric intensive care unit (PICU) with suspected non-accidental injury (NAI). Methods: A retrospective descriptive study of routinely collected data from all children admitted to the PICU with suspected NAI from 1 January 2012 to 31 December 2020. Results: Of 11345 children admitted to PICU, 42 (0.4%) patients with suspected NAI (median (IQR) age 20.3 (7.9 – 62.6) months; 61.9% male) were included in the data analysis. Most patients sustained physical injury (n=31; 73.8%) from assaults (n=19; 45.2%), and head injuries were the most common injury site (n=24; 57.1%). Of the patients, 37 (88.1%) received invasive mechanical ventilation for median 2.0 (IQR) (1.0 – 3.8) days. PICU mortality was 28.6% (n=12), with a risk adjusted mortality (observed/mean predicted mortality) of 3.2. Of the 30 PICU survivors, 7 (23.3%) were discharged with long-term disability, whilst the functional outcome of 16 (53.3%) survivors is not known. A multivariable binary logistic regression was conducted to determine the effect of inotropes, type of NAI, mechanism of injury, injury site (head, skin – eye injuries removed from the model for reasons of collinearity), and multiple injuries on patient survival. The model was significant (p = 0.001) and a good fit for the data (Nagelkerke R square 0.78) and was able to correctly predict 85.7% of cases. None of the variables in the model were r found to be independently associated with survival (p > 0.1 for all). Conclusions: Children who have sustained NAI represent a small proportion of PICU admissions, with higher-than-expected mortality and considerable morbidity. Patient follow-up is recommended to determine long-term functional and psychosocial outcomes.
dc.identifier.apacitationBowes, L. (2025). <i>Children admitted to Paediatric Intensive Care at Red Cross War Memorial Children?s Hospital with Non-Accidental injuries (2012-2020): a retrospective descriptive study</i>. (). University of Cape town ,Faculty of Health Sciences ,Department of Paediatrics and Child Health. Retrieved from http://hdl.handle.net/11427/41492en_ZA
dc.identifier.chicagocitationBowes, Lynelle. <i>"Children admitted to Paediatric Intensive Care at Red Cross War Memorial Children?s Hospital with Non-Accidental injuries (2012-2020): a retrospective descriptive study."</i> ., University of Cape town ,Faculty of Health Sciences ,Department of Paediatrics and Child Health, 2025. http://hdl.handle.net/11427/41492en_ZA
dc.identifier.citationBowes, L. 2025. Children admitted to Paediatric Intensive Care at Red Cross War Memorial Children?s Hospital with Non-Accidental injuries (2012-2020): a retrospective descriptive study. . University of Cape town ,Faculty of Health Sciences ,Department of Paediatrics and Child Health. http://hdl.handle.net/11427/41492en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - Bowes, Lynelle AB - Objectives: To describe the characteristics and outcomes of patients admitted to the paediatric intensive care unit (PICU) with suspected non-accidental injury (NAI). Methods: A retrospective descriptive study of routinely collected data from all children admitted to the PICU with suspected NAI from 1 January 2012 to 31 December 2020. Results: Of 11345 children admitted to PICU, 42 (0.4%) patients with suspected NAI (median (IQR) age 20.3 (7.9 – 62.6) months; 61.9% male) were included in the data analysis. Most patients sustained physical injury (n=31; 73.8%) from assaults (n=19; 45.2%), and head injuries were the most common injury site (n=24; 57.1%). Of the patients, 37 (88.1%) received invasive mechanical ventilation for median 2.0 (IQR) (1.0 – 3.8) days. PICU mortality was 28.6% (n=12), with a risk adjusted mortality (observed/mean predicted mortality) of 3.2. Of the 30 PICU survivors, 7 (23.3%) were discharged with long-term disability, whilst the functional outcome of 16 (53.3%) survivors is not known. A multivariable binary logistic regression was conducted to determine the effect of inotropes, type of NAI, mechanism of injury, injury site (head, skin – eye injuries removed from the model for reasons of collinearity), and multiple injuries on patient survival. The model was significant (p = 0.001) and a good fit for the data (Nagelkerke R square 0.78) and was able to correctly predict 85.7% of cases. None of the variables in the model were r found to be independently associated with survival (p > 0.1 for all). Conclusions: Children who have sustained NAI represent a small proportion of PICU admissions, with higher-than-expected mortality and considerable morbidity. Patient follow-up is recommended to determine long-term functional and psychosocial outcomes. DA - 2025 DB - OpenUCT DP - University of Cape Town KW - Medicine LK - https://open.uct.ac.za PB - University of Cape town PY - 2025 T1 - Children admitted to Paediatric Intensive Care at Red Cross War Memorial Children?s Hospital with Non-Accidental injuries (2012-2020): a retrospective descriptive study TI - Children admitted to Paediatric Intensive Care at Red Cross War Memorial Children?s Hospital with Non-Accidental injuries (2012-2020): a retrospective descriptive study UR - http://hdl.handle.net/11427/41492 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/41492
dc.identifier.vancouvercitationBowes L. Children admitted to Paediatric Intensive Care at Red Cross War Memorial Children?s Hospital with Non-Accidental injuries (2012-2020): a retrospective descriptive study. []. University of Cape town ,Faculty of Health Sciences ,Department of Paediatrics and Child Health, 2025 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/41492en_ZA
dc.language.rfc3066Eng
dc.publisher.departmentDepartment of Paediatrics and Child Health
dc.publisher.facultyFaculty of Health Sciences
dc.publisher.institutionUniversity of Cape town
dc.subjectMedicine
dc.titleChildren admitted to Paediatric Intensive Care at Red Cross War Memorial Children?s Hospital with Non-Accidental injuries (2012-2020): a retrospective descriptive study
dc.typeThesis / Dissertation
dc.type.qualificationlevelMasters
dc.type.qualificationlevelMMed
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