{"id":{"repo_id":"cape-town","oai_identifier":"oai:open.uct.ac.za:11427/41492"},"canonical_url":"https://search.dev.ndltd.org/etd/cape-town/oai:open.uct.ac.za:11427/41492","repository":{"repo_id":"cape-town","name":"University of Cape Town","base_url":"https://open.uct.ac.za/oai/request"},"display":{"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","abstract":"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.","abstract_html":"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.","abstract_has_math":false,"creators":["Bowes, Lynelle"],"institution":"Department of Paediatrics and Child Health","degree_name":null,"degree_level":null,"degree_discipline":null,"degree_department":null,"school":null,"contributors":[],"advisors":["Morrow, Brenda","Rossouw Beyra"],"committee_chairs":[],"committee_members":[],"year":2025,"date_issued":"2025","date_published":"2025","updated_at":"2026-07-22T22:23:46Z","subjects":["Medicine"],"languages":[],"rights":[],"rights_urls":[],"identifier_entries":[]},"links":{"outbound_url":"http://hdl.handle.net/11427/41492","outbound_label":"Handle","outbound_source":"dc:identifier.uri"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:contributor.advisor","label":"Advisor","values":["Morrow, Brenda","Rossouw Beyra"]},{"key":"dc:creator","label":"Author","values":["Bowes, Lynelle"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:date.accessioned","label":"Dc Date Accessioned","values":["2025-06-25T13:18:59Z"]},{"key":"dc:date.available","label":"Dc Date Available","values":["2025-06-25T13:18:59Z"]},{"key":"dc:date.issued","label":"Date","values":["2025"]},{"key":"dc:publisher.department","label":"Dc Publisher Department","values":["Department of Paediatrics and Child Health"]},{"key":"dc:publisher.institution","label":"Dc Publisher Institution","values":["University of Cape town"]},{"key":"dc:type","label":"Dc Type","values":["Thesis / Dissertation"]},{"key":"dc:type.qualificationlevel","label":"Dc Type Qualificationlevel","values":["Masters","MMed"]}]},{"id":"subjects_keywords","label":"Subjects and Keywords","entries":[{"key":"dc:subject","label":"Dc Subject","values":["Medicine"]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier.uri","label":"Identifier URI","values":["http://hdl.handle.net/11427/41492"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description.abstract","label":"Abstract","values":["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."]},{"key":"dc:title","label":"Title","values":["Children admitted to Paediatric Intensive Care at Red Cross War Memorial Children?s Hospital with Non-Accidental injuries (2012-2020): a retrospective descriptive study"]}]}],"canonical_facts":{"dc:contributor.advisor":["Morrow, Brenda","Rossouw Beyra"],"dc:creator":["Bowes, Lynelle"],"dc:date.accessioned":["2025-06-25T13:18:59Z"],"dc:date.available":["2025-06-25T13:18:59Z"],"dc:date.issued":["2025"],"dc:description.abstract":["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."],"dc:identifier.uri":["http://hdl.handle.net/11427/41492"],"dc:publisher.department":["Department of Paediatrics and Child Health"],"dc:publisher.institution":["University of Cape town"],"dc:subject":["Medicine"],"dc: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"],"dc:type":["Thesis / Dissertation"],"dc:type.qualificationlevel":["Masters","MMed"]},"updated_at":"2026-07-22T22:23:46Z"}