Paediatric trauma and hypocalcaemia: a systematic review.

IF 4.3 3区 医学 Q1 PEDIATRICS
Mary-Beth Toner, Michael Coffey, Ulugbek Nurmatov, Stephen Mullen
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引用次数: 0

Abstract

Background: Trauma is a leading cause of mortality and morbidity in children worldwide. While adult studies have demonstrated hypocalcaemia's association with adverse outcomes, its impact on paediatric trauma patients remains understudied. This systematic review aims to investigate current evidence into the prevalence, clinical implications and associations of hypocalcaemia in paediatric trauma.

Methods: A comprehensive literature search was conducted searching four databases, grey literature and additional sources for original studies looking at outcomes for paediatric trauma patients with ionised calcium measurements before blood product administration. Exclusion criteria comprised studies which included patients with blood product administration prior to calcium measurement, case reports, case series, reviews and papers not available in English. The review protocol is registered with the International Prospective Register of Systematic Reviews (PROSPERO): CRD42023432473. Data extraction was performed on included papers and quality assessment performed using Newcastle-Ottawa Scale.

Results: Of 779 initial studies, two studies met inclusion criteria for detailed analysis. Both retrospective cohort studies originated in Israel and collectively included 568 patients. Hypocalcaemia incidence ranged from 5.3% to 19.8%. Although trends towards increased mortality, blood transfusion requirements and prolonged hospital stays were observed in patients with hypocalcaemia, statistical significance was not consistently achieved.

Conclusion: Hypocalcaemia in paediatric trauma appears reduced in incidence compared with adult populations. Limited available studies suggest potential associations with adverse outcomes, although most were not statistically significant. Studies had small patient numbers, necessitating further prospective research to facilitate a clearer understanding. Insights from such studies can guide patient management and improve outcomes in this vulnerable population.

Prospero registration number: CRD42023432473.

儿科创伤和低钙血症:一项系统综述。
背景:创伤是全世界儿童死亡和发病的主要原因。虽然成人研究已经证明低钙血症与不良后果相关,但其对儿科创伤患者的影响仍未得到充分研究。本系统综述的目的是调查目前的证据患病率,临床意义和低钙血症在儿科创伤的关联。方法:对四个数据库、灰色文献和其他原始研究来源进行全面的文献检索,以观察在给血制品前进行电离钙测量的儿科创伤患者的结果。排除标准包括在钙测量前使用血液制品的患者、病例报告、病例系列、评论和非英文论文的研究。该评价方案已在国际前瞻性系统评价注册中心(PROSPERO)注册:CRD42023432473。对纳入的论文进行数据提取,并使用纽卡斯尔-渥太华量表进行质量评估。结果:在779项初始研究中,有2项研究符合详细分析的纳入标准。两项回顾性队列研究均起源于以色列,共纳入568例患者。低钙血症的发生率从5.3%到19.8%不等。虽然在低钙血症患者中观察到死亡率、输血需求和住院时间延长的趋势,但统计意义并不一致。结论:与成人相比,儿童外伤低钙血症的发生率有所降低。有限的现有研究表明与不良结果的潜在关联,尽管大多数没有统计学意义。研究的患者数量较少,需要进一步的前瞻性研究以促进更清晰的理解。从这些研究中获得的见解可以指导患者管理并改善这一弱势群体的预后。普洛斯彼罗注册号:CRD42023432473。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
5.80
自引率
3.80%
发文量
291
审稿时长
3-6 weeks
期刊介绍: Archives of Disease in Childhood is an international peer review journal that aims to keep paediatricians and others up to date with advances in the diagnosis and treatment of childhood diseases as well as advocacy issues such as child protection. It focuses on all aspects of child health and disease from the perinatal period (in the Fetal and Neonatal edition) through to adolescence. ADC includes original research reports, commentaries, reviews of clinical and policy issues, and evidence reports. Areas covered include: community child health, public health, epidemiology, acute paediatrics, advocacy, and ethics.
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