PURPOSE: The purpose of this study was to assess severe abdominal injury in child passengers of different ages of motor vehicle accidents and analyze the concomitant pattern of injury regarding injury severity, trauma management and outcome. METHOD: Data acquisition from Trauma Register DGU RESULTS: The study group (cMVP) included 1,035 children. The mean age was 9.5 years, 50.5% were male and the mean Injury Severity Score (ISS) was 18.7 points. 93.0% were transported from scene directly to the final trauma center. Transferred patients showed a higher ISS (26 vs. 18 points), higher rate of severe traumatic brain injury (TBI), a higher rate of serious abdominal injury and a higher mortality rate (12.5% vs. 7.4%). Most of the severe abdominal injuries occurred after the third year of age (first peak between 8 and 9 years
second peak 14-15 years). Serious injuries to the pelvis show a similar distribution but less often, the same applies to thoracical injuries. Severe brain and head injuries show an antiproportional distribution to the age groups with the highest rate in the 0-1 year old (78%) and the lowest in the 14-15 year old (40%). The highest mortality rate was shown in the youngest age groups, related to TBI (AIS CONCLUSION: Child passengers of motor vehicle accidents are in need of a specific and age-related attention towards security systems. Severe injuries in children are rare, yet life threatening. The highest mortality rate is related to severe TBI, especially in the youngest children. But also severe abdominal as well as thoracic injuries their concomitant trauma need to be prevented and are indicators for even more severe injuries. It seems to be favorable for cMVP to be directly transported to designated special centers with sufficient capacity and competency to treat and manage severely injured children.