Abstract

BOWES, L; ROSSOUW, B  and  MORROW, B M. Children admitted to paediatric intensive care at Red Cross War Memorial Children's Hospital with non-accidental injuries (2012 - 2020): A retrospective descriptive study. South. Afr. j. crit. care (Online) [online]. 2026, vol.42, n.1, pp.28-32. ISSN 2078-676X.  https://doi.org/10.7196/sajcc.2026.v42i1.3260.

BACKGROUND: Violence against children remains common in South Africa (SA). Children sustaining severe non-accidental injuries (NAIs) may require admission to paediatric intensive care units (PICUs), however, their outcomes have not been well described in SA. OBJECTIVES: To describe the characteristics and outcomes of patients admitted to the PICU with suspected NAIs at Red Cross War Memorial Children's Hospital (RCWMCH). METHODS: A retrospective descriptive study of routinely collected data from all children admitted to the PICU at RCWMCH with suspected NAIs from 1 January 2012 to 31 December 2020. RESULTS: Of 11 345 children admitted to the PICU, 42 (0.4%) patients with suspected NAI (median (IQR) age 20.3 (7.9 - 62.6) months; 61.9% male) were included in data analysis. Most patients sustained physical injury (n=35; 83.3%) from assaults (n=19; 45.2%), and head injuries were the most common injury site, while 37 (88.1%) received invasive mechanical ventilation for a median (interquartile range) of 2.0 (1.0 - 3.8) days. PICU mortality was 28.6% (n=12), with a risk-adjusted mortality (observed/mean predicted mortality) of 3.6. Of the 30 PICU survivors, 7 (23.3%) were discharged with long-term disability, while the functional outcome of 16 (53.3%) survivors remains unknown. CONCLUSIONS: Children who have sustained NAI represent a small proportion of PICU admissions, with high mortality and considerable morbidity.

Keywords : non-accidental injuries; intensive care units; paediatric; hospital mortality; wounds; injuries; South Africa.

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