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Children admitted to Paediatric Intensive Care at Red Cross War Memorial Children?s Hospital with Non-Accidental injuries (2012-2020): a retrospective descriptive study
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...
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| Format: | Thesis |
| Language: | Eng |
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Department of Paediatrics and Child Health
2025
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| _version_ | 1867614414155284480 |
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| access_status_str | Open Access |
| author | Bowes, Lynelle |
| author2 | Morrow, Brenda |
| author_browse | Bowes, Lynelle Morrow, Brenda |
| author_facet | Morrow, Brenda Bowes, Lynelle |
| author_sort | Bowes, Lynelle |
| collection | Thesis |
| description | 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. |
| format | Thesis |
| id | oai:open.uct.ac.za:11427/41492 |
| institution | University of Cape Town (South Africa) |
| language | Eng |
| last_indexed | 2026-06-10T12:51:39.729Z |
| license_str | Not specified — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository |
| publishDate | 2025 |
| publishDateRange | 2025 |
| publishDateSort | 2025 |
| publisher | Department of Paediatrics and Child Health |
| publisherStr | Department of Paediatrics and Child Health |
| record_format | dspace |
| source_str | UCTD — University of Cape Town Open Access Repository |
| spelling | oai:open.uct.ac.za:11427/41492 Children admitted to Paediatric Intensive Care at Red Cross War Memorial Children?s Hospital with Non-Accidental injuries (2012-2020): a retrospective descriptive study Bowes, Lynelle Morrow, Brenda Rossouw Beyra Medicine 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. 2025-06-25T13:18:59Z 2025-06-25T13:18:59Z 2025 2025-06-25T13:14:56Z Thesis / Dissertation Masters MMed http://hdl.handle.net/11427/41492 Eng application/pdf Department of Paediatrics and Child Health Faculty of Health Sciences University of Cape town |
| spellingShingle | Medicine Bowes, Lynelle Children admitted to Paediatric Intensive Care at Red Cross War Memorial Children?s Hospital with Non-Accidental injuries (2012-2020): a retrospective descriptive study |
| thesis_degree_str | Master's |
| title | Children admitted to Paediatric Intensive Care at Red Cross War Memorial Children?s Hospital with Non-Accidental injuries (2012-2020): a retrospective descriptive study |
| title_full | Children admitted to Paediatric Intensive Care at Red Cross War Memorial Children?s Hospital with Non-Accidental injuries (2012-2020): a retrospective descriptive study |
| title_fullStr | Children admitted to Paediatric Intensive Care at Red Cross War Memorial Children?s Hospital with Non-Accidental injuries (2012-2020): a retrospective descriptive study |
| title_full_unstemmed | Children admitted to Paediatric Intensive Care at Red Cross War Memorial Children?s Hospital with Non-Accidental injuries (2012-2020): a retrospective descriptive study |
| title_short | Children admitted to Paediatric Intensive Care at Red Cross War Memorial Children?s Hospital with Non-Accidental injuries (2012-2020): a retrospective descriptive study |
| title_sort | children admitted to paediatric intensive care at red cross war memorial children s hospital with non accidental injuries 2012 2020 a retrospective descriptive study |
| topic | Medicine |
| url | http://hdl.handle.net/11427/41492 |
| work_keys_str_mv | AT boweslynelle childrenadmittedtopaediatricintensivecareatredcrosswarmemorialchildrenshospitalwithnonaccidentalinjuries20122020aretrospectivedescriptivestudy |