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Transient elevation in risk of injury in siblings following injury encounters
Brian D Johnston1, David C Grossman, Robert S Thompson
1Division of General Pediatrics, Department of Pediatrics, Harborview Injury Prevention and Research Center, Seattle, Washington, USA.
Insights
Children with a recently injured sibling face a higher risk of injury themselves. A doctor
Area of Science:
- Pediatric injury prevention research.
- Public health and epidemiology of childhood injuries.
- Family dynamics and health risk behaviors.
Background:
- Childhood injuries represent a significant public health concern.
- Understanding familial risk factors for injury is crucial for prevention.
- Previous research has not fully explored shared injury risk among siblings.
Purpose of the Study:
- To investigate injury risk patterns within sibling groups.
- To determine if a clinical injury encounter can identify at-risk siblings.
- To assess the potential of using injury events as a predictive marker.
Main Methods:
- Analysis of medically treated, unintentional injuries in 16,335 children (0-15 years).
- Data collected from a health maintenance organization (1995-1997) over 38,215 child-years.
- Comparison of injury incidence rates between children with and without a recently injured sibling (within 180 days), adjusted for covariates.
Main Results:
- Children with a recently injured sibling had a 44% higher injury incidence (319 vs. 235 per 1,000 child-years; RR=1.44).
- Excluding minor injuries, the relative risk increased significantly (RR=1.95), indicating a stronger association for more severe injuries.
- Injury risk is demonstrably shared within sibling units.
Conclusions:
- Sibling groups share injury risks, influenced by recent injury experiences.
- Clinical encounters for injury care may serve as a valuable marker for identifying siblings at elevated risk.
- This finding supports targeted injury prevention strategies within families.
Objective:
To examine patterns of injury risk within sibling groups to determine whether a clinical encounter for injury care could be used as a marker to identify siblings at high risk for subsequent injury.
Study Design:
Children (n = 16,335; 0-15 years of age) enrolled in a health maintenance organization between 1995 and 1997 contributed 38,215 child-years of data. We tracked medically treated injuries that were diagnosed and classified as unintentional. Incidence rates and hazard ratios were calculated for children whose sibling had been injured in the previous 180 days compared with children without such exposure, adjusted for age, sex, sibling group size, and noninjury health care utilization.
Results:
The 5,851 children had a total of 8,973 injuries. Injury incidence was 319 per 1,000 child-years among children with recent sibling injury and 235 per 1,000 child-years among children without this exposure (relative risk, 1.44; 95% CI, 1.36-1.53). When minor injuries were excluded, the adjusted relative risk was 1.95 (95% CI, 1.54-2.47).
Conclusions:
Injury risk is shared within sibling groups and varies according to recent sibling injury experience. Clinical encounters for injury care might be used to identify sibling groups at increased injury risk.
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