Pédiatrie de guerre : caractéristiques épidémiologiques des admissions en réanimation à l'hôpital médicochirurgical de Kaboul

Describe the epidemiological characteristics of paediatrics admissions in the critical care unit of the medical and surgical hospital in Kabul. A retrospective epidemiological study was conducted. The files of all the children of less than 18-year-old admitted into the intensive care unit of the hospital between May 2010 and August 2012 were analysed. The three age groups, 0-8 years old, 9-14 years old and 15-17 years old as well as the traumas linked or not to combat, were compared. One hundred and eleven children were admitted in the critical car unit, representing 21% of admissions. Traumatology represented 92% of admissions reasons. The average age was 9.4 ± 4 year-old; the average length of stay in the critical care unit was 5.3 ± 5 days. Nine out 111 children died in the critical care unit (8.1%). The trauma cause was a blast in 36.5% of cases, a blunt trauma in 31.7% and a penetrating trauma in 22.1%. The main injury mechanisms were explosions (37.5%) and gunfire wounds (22%). The average ISS was at 15 ± 10. The traumas linked to combat represented 66% of admissions. Compared to the traumas not linked to combat, they were significantly more severe (ISS 17 vs. 11 P = 0.007, number of anatomic regions traumatised 2.3 vs. 1.7 P = 0.007). Our results show an important paediatric activity during the Afghan conflict. The children treated presented a severe trauma in the majority of cases.