The investigation of 0 - 1 years child trauma cases in The Afyon Kocatepe University Medical Faculty Hospital emergency service between 2014-2017

Trauma is a public health problem which is the most common cause of death and disability in young people. When epidemiological evaluations of pediatric age group injuries are made, it is seen that these traumas are preventable diseases rather than accidents. Although childhood injuries are common and epidemiology has been described, studies focusing on younger children and infants are rare. The aim of this study was to describe trauma patterns in babies and their injuries. In this study, 1269 cases among the trauma cases under 1 year of age admitted to the emergency department of Afyonkarahisar Health Sciences University Medical Faculty Hospital (AFSU) between January 2014 - December 2017 were included in the study. Drowning, electric shock, foreign body aspiration and intoxication were not included in the study.The files of the patients included in the study evaluated and the hospital automation system information about patients which include age, gender, admission time, admission time, referral form, type of trauma, forensic case status, presence of suspicion of abuse, GCS score, AVPU score, loss of consciousness from referring features, tendency to sleep, number of vomiting, presence of abnormal movement by family, history of seizures after trauma, the presence of unacceptable crying, physical examination findings, injured body regions were recorded. Blood tests, X-ray, CT, USG tests and results, procedures, consultation requests, hospitalization and discharge status were examined and processed in the data collection form. The patients included in the study who were admitted to our hospital with head injury within the first 24 hours of the event, were evaluated whether CT traction was recommended according to PECARN, CATCH, CHALICE rules. Patients with and without CT were compared to those with brain CT scan. SPSS (Statistical Package for Social Sciences) program for Windows 23.0 (IBM) was used for the statistical analysis of the data obtained in the study.The mean age of the study group was 7.28 months and 53.3% of the 1269 patients under the age of 1 were male. Among the causes of injury, falls from the high were in the first place, falls from the same level were in second and traffic accidents were in third place In the study, it was thought that the high incidence of falling from height in this region was related to the local baby cradles which were established at high. 10.6% of the cases were evaluated as child abuse. The mean age of the patients with suspicion of abuse was lower. In this study, the most common complaint was vomiting with a rate of 10.8%. In the cases, the most common type of injury was face injury (20.8%), while the least type of injury was abdominal (0.3%), thorax (0.6%) and multiple (0.6%) injuries. At the time of application, 99.7% of the cases had a GCS of 15. The most common method for diagnosis was CT. Of the 1086 cases with head trauma (85.6%), 879 (80.9%) of the patients had head-neck CT, and 105 (11.9%) had pathological findings. Thoracic CT was performed in 8.4% of all cases and pathology was found in 0.6% of all cases. Abdominal pelvis CT was performed in 6.5% of the cases and pathology was found in 0.2% of the cases. Abdominal USG was performed in 3.5% of the cases and pathology was found in 0.1% of the cases. X-ray was performed in 51.5% of the cases and pathology was found in 49 (7.5%) cases. A blood test of 28.2% was examined and it was seen that 70% of the patients had blood test parameters in the expected range. 20.1% of the cases were consulted to other clinical departments. Most of the cases (10%) was consulted to brain surgery department. 8% of the cases were hospitalized. The most hospitalized department was brain surgery (82) (6.5%). 101 of 102 patients who were hospitalized were discharged from the clinic. One patient refused the treatment and discharged from the clinic. All 1086 cases with head trauma were GCS> 13 except one. 80.9% of the patients had a CT scan. Head bone fracture was detected in 10% of the patients at CT scan, 1% of TBI and 0.9% of the patients with bone fracture were detected. None of the patients with TBI required intubation and surgical intervention and were discharged after follow-up. In patients with abnormal head and neck CT findings, sleep tendency and seizures were significantly higher. In the head and neck examination, scalp incision, any skin lesion (abrasion, ecchymosis, hyperemia) and nonfrontal hematoma were found tobe significant in terms of CT pathology findings. The rate of pathology in head and neck CT was significantly higher in patients with suspicion of abuse. PECARN rule was found to be 897 (87.1%), CATCH rule was found to be 888 (86.2%) and CHALICE rule was found to be 152 (14.8%) of cases. For the detection of pathology in CT, the sensitivity of the CATCH rule was 51% with a specificity of 87.9%, the sensitivity of the CHALICE rule with a specificity of 40.1%, a sensitivity of 13.4%, and a sensitivity of 10% to 87.9%.Pediatric trauma patients are more prone to trauma due to their anatomical and physiological differences compared to adult patient groups. The causes and conditions of infant injuries may vary depending on community and location due to differences in home and community settings and practices. Injuries of young children are often a major health problem because they occur in the home environment and are particularly preventable, but there are few population-based analyzes in how prevention initiatives will be developed. As there are few studies in the literature about the evaluation of traumas in children under 1 year, it is thought that our study may contribute to the literature.