{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T10:09:21Z","timestamp":1788948561655,"version":"build-2803163510"},"reference-count":17,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T00:00:00Z","timestamp":1788825600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T00:00:00Z","timestamp":1788912000000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100004047","name":"Karolinska Institute","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100004047","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Pediatr"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Paediatric trauma mortality is uncommon in well-resourced systems, limiting clinical exposure and necessitating system-level learning through detailed review of individual deaths. This retrospective descriptive case series characterises paediatric trauma deaths following trauma-call activation at Karolinska University Hospital (KUH), Stockholm, Sweden\u2019s primary level 1 trauma centre, between 2016 and 2025. Eligible cases were patients aged 0\u201317 years who triggered trauma-team activation, were entered into the Karolinska Trauma Registry, and died within 30 days of injury.<\/jats:p>\n                  <jats:p>Among 1,792 paediatric trauma-call activations, 28 patients died, corresponding to a 30-day case fatality rate of 1.6% among activated trauma patients. The cohort comprised 16 males and 12 females (median age 15), and critical injury severity (New Injury Severity Score [NISS]\u2009\u2265\u200925) was observed in 25 of 26 cases.<\/jats:p>\n                  <jats:p>Penetrating trauma accounted for most deaths (15\/28), mainly stabbings and gunshot wounds; assault was recorded in half of cases, and prehospital cardiac arrest occurred in 17 patients. Isolated head injury was the most common injury pattern (12\/28, 42.9%), followed by thoracoabdominal injury (4\/28, 14.3%). The leading recorded causes of death were haemorrhagic shock (14\/28, 50.0%) and traumatic brain injury (12\/28, 42.9%); cause of death was unavailable in 2 cases (7.1%).<\/jats:p>\n                  <jats:p>Fatal paediatric trauma following trauma-call activation was rare but characterised by severe injury and a substantial burden of violence-related penetrating trauma. The reported case fatality rate applies only to trauma-call activations captured in the registry and should not be interpreted as mortality among all injured children in the region. Detailed case-level review may support clinical audit, service evaluation, and prevention strategies targeting interpersonal violence among children and adolescents.<\/jats:p>","DOI":"10.1186\/s12887-026-07618-4","type":"journal-article","created":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T08:04:06Z","timestamp":1788854646000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Paediatric trauma mortality at a level 1 trauma centre: a retrospective case series at Karolinska University Hospital, Stockholm"],"prefix":"10.1186","volume":"26","author":[{"given":"Ammar","family":"Yaqoob","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-0020-6221","authenticated-orcid":false,"given":"Shahzad","family":"Akram","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,8]]},"reference":[{"issue":"1","key":"7618_CR1","doi-asserted-by":"publisher","first-page":"e16","DOI":"10.1016\/S2214-109X(23)00496-5","volume":"12","author":"F Villavicencio","year":"2024","unstructured":"Villavicencio F, Perin J, Eilerts-Spinelli H, et al. Global, regional, and national causes of death in children and adolescents younger than 20 years: an open data portal with estimates for 2000\u201321. Lancet Glob Health. 2024;12(1):e16\u20137.","journal-title":"Lancet Glob Health"},{"key":"7618_CR2","unstructured":"Socialstyrelsen S. 2024. Available from: https:\/\/www.socialstyrelsen.se\/statistik-och-data\/statistik\/alla-statistikamnen\/dodsorsaker\/. Cited 2026 Feb 14."},{"issue":"4","key":"7618_CR3","doi-asserted-by":"publisher","first-page":"308","DOI":"10.1007\/s00068-009-9080-6","volume":"36","author":"K Sluys","year":"2010","unstructured":"Sluys K, Lannge M, Iselius L, Eriksson LE. Outcomes in Pediatric Trauma Care in the Stockholm Region. Eur J Trauma. 2010;36(4):308\u201317.","journal-title":"Eur J Trauma"},{"issue":"9","key":"7618_CR4","doi-asserted-by":"publisher","first-page":"874","DOI":"10.1001\/jamasurg.2015.1121","volume":"150","author":"C Sathya","year":"2015","unstructured":"Sathya C, Alali AS, Wales PW, et al. Mortality Among Injured Children Treated at Different Trauma Center Types. JAMA Surg. 2015;150(9):874\u201381.","journal-title":"JAMA Surg"},{"issue":"9","key":"7618_CR5","doi-asserted-by":"publisher","first-page":"e2334266","DOI":"10.1001\/jamanetworkopen.2023.34266","volume":"6","author":"L Moore","year":"2023","unstructured":"Moore L, Freire G, Turgeon AF, et al. Pediatric vs Adult or Mixed Trauma Centers in Children Admitted to Hospitals Following Trauma: A Systematic Review and Meta-analysis. JAMA Netw Open. 2023;6(9):e2334266.","journal-title":"JAMA Netw Open"},{"issue":"7","key":"7618_CR6","doi-asserted-by":"publisher","first-page":"186","DOI":"10.1007\/s40137-024-00406-y","volume":"12","author":"AC Greene","year":"2024","unstructured":"Greene AC, Shpigel M, Sandifer SP, Safford SD. Pediatric Trauma\u2014Not Just Little Adults\u2014Part 1: Differences in Physiology and Injury Patterns. 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Clinical and Physiologic Factors Associated With Mode of Death in Pediatric Severe Traumatic Brain Injury. 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Approval was granted by the Swedish Ethical Review Authority, diary number 2024-03805-01, with addendum 2025-08751-02. Consent to participate was not applicable because data collection and analysis were registry-based and anonymised.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"845"}}