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A 4-year review of severe pediatric trauma in eastern Ontario: a descriptive analysis
Martin H Osmond1, Maureen Brennan-Barnes, Allyson L Shephard
1Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada. osmond@cheo.on.ca
Insights
Severe pediatric trauma in children is often caused by motor vehicle accidents, falls, and child abuse. Injury prevention efforts should prioritize road safety, head protection, fall avoidance, and child abuse prevention strategies.
Area of Science:
- Pediatric Trauma Research
- Injury Prevention Science
- Public Health
Background:
- Understanding the epidemiology of severe pediatric trauma is crucial for developing targeted prevention strategies.
- Tertiary care pediatric hospitals serve as key centers for managing severe pediatric trauma cases.
Purpose of the Study:
- To characterize the population of children admitted with severe trauma to a pediatric hospital.
- To identify primary causes of severe pediatric trauma for injury prevention research and programming.
Main Methods:
- Retrospective chart review of children (0-17 years) admitted for acute trauma.
- Inclusion criteria: Injury Severity Score (ISS) > 11.
- Data collected from April 1996 to March 2000 at the Children's Hospital of Eastern Ontario (CHEO).
Main Results:
- 237 (9.1%) of 2610 trauma cases were classified as severe (ISS > 11).
- Leading causes included motor vehicle traffic (39%), falls (24%), child abuse (8%), and sports (5%).
- Head and neck injuries were most common (65%), with motor vehicle incidents being a significant factor, especially for occupants, pedestrians, and cyclists.
Conclusions:
- Future injury prevention initiatives should focus on road safety, particularly for vehicle occupants, pedestrians, and cyclists.
- Strategies to prevent head injuries and falls are essential.
- Addressing child abuse is a critical component of severe pediatric trauma prevention.
Background:
The objective of this study was to describe a population of children admitted to a tertiary care pediatric hospital with severe trauma to identify key areas for injury prevention research, and programming.
Methods:
Retrospective chart review conducted on all children 0-17 years admitted to the Children's Hospital of Eastern Ontario (CHEO) between April 1, 1996, and March 31, 2000, following acute trauma. Each record was reviewed and assigned an ISS using the AIS 1990 revision. All cases with an ISS > 11 were included in the study.
Results:
There were 2610 trauma cases admitted to CHEO over the study period. Of these, 237 (9.1%) had severe trauma (ISS > 11). Sixty-two percent were male. Twenty-nine percent were between the ages of 10 and 14 years, 27% between 5 and 9 years, 16% between 15 and 17 years, 15% between 1 and 4 years, and 13% less than 1 year old. The most common mechanisms of injury were due to motor vehicle traffic (39%), falls (24%), child abuse (8%), and sports (5%). Of those resulting from motor vehicle traffic, 53 (57%) were occupants, 22 (24%) were pedestrians, and 18 (19%) were cyclists. When combining traffic and nontraffic mechanisms, 26 (11% of all severe trauma cases) occurred as a result of cycling incidents. The most severe injury in 65% of patients was to the head and neck body region.
Conclusion:
Research efforts and activities to prevent severe pediatric trauma in our region should focus on road safety, protection from head injuries, avoidance of falls, and prevention of child abuse.