The impact of pediatric trauma in the Amish community
Melissa A Vitale1, Susan Rzucidlo, Michele L Shaffer
1Department of Pediatrics, Division of Pediatric Surgery, Pennsylvania State University College of Medicine, Hershey, 17033, USA.
Insights
Traumatic injuries in Amish children, often from falls, animal incidents, or buggy accidents, lead to significant morbidity and mortality. Targeted education could reduce these unique injury events.
Area of Science:
- Pediatric Trauma Epidemiology
- Public Health
- Injury Prevention
Background:
- The Amish population exhibits unique cultural and lifestyle factors that may influence injury patterns.
- Understanding the epidemiology of trauma in this specific demographic is crucial for targeted interventions.
Purpose of the Study:
- To delineate the epidemiology of traumatic injuries among Amish children.
- To identify variations in treatment and outcomes based on injury mechanisms in this population.
Main Methods:
- Retrospective review of hospital admission data for Amish children with trauma.
- Statistical analysis including chi-square, logistic regression, Fisher exact test, and analysis of variance to compare outcomes.
Main Results:
- Falls, buggy versus motor vehicle accidents (MVA), and animal injuries were the most common mechanisms.
- Animal injuries and buggy versus MVA were significantly associated with increased need for surgery, longer hospital stays, and greater severity.
- Overall mortality was 3%, with significant associations between injury mechanism and outcome scores and hospital charges.
Conclusions:
- The spectrum of traumatic injuries in Amish children is distinct and contributes to significant morbidity, mortality, and economic burden.
- Preventive education strategies may be effective in reducing the incidence of these unique traumatic events.
Objective:
To describe the epidemiology of trauma in Amish children and to determine differences in treatment and outcome related to injury mechanism.
Study Design:
In this retrospective review, data were collected on all Amish children with trauma requiring hospital admission. Demographic, interventional, and outcome data were collected. Categorical outcomes were compared by using chi-square, logistic regression, or Fisher exact test; continuous outcomes were compared with analysis of variance.
Results:
A total of 135 trauma admissions were studied. There was a significant difference of proportion of injury by month (P < .01). The most common mechanisms of injury were falls (39%), buggy versus motor vehicle accidents (MVA; 16%), and animal injuries (14%). A total of 41% of patients required operative procedures, and 50% of subjects required intensive care. Animal injuries and buggy versus MVA were significantly associated with a requirement for surgery, increased length of stay, and increased severity (all P < .01). The overall mortality rate was 3%. There were significant associations between mechanism of injury and outcome scores (P < .05) and hospital charges (P < .05).
Conclusions:
The spectrum of traumatic injuries is unique among Amish children. These injuries contribute significantly to morbidity and mortality and impose a large monetary burden on the Amish community. Education may decrease the incidence of these events.
