Preventable pediatric trauma deaths in Ontario: a comparative population-based study

Area of Science:

• Pediatric Trauma Care
• Injury Prevention Research
• Public Health Systems Analysis

Background:

• Previous studies identified 21% of pediatric trauma deaths in Ontario (1985-1987) as preventable.
• Significant trauma system enhancements have been implemented since the initial study period.

Purpose of the Study:

• To re-evaluate the preventable trauma death rate in pediatric (<16 years) patients in Ontario.
• To assess the impact of trauma system improvements on mortality rates using consistent methodology.

Main Methods:

• Analysis of pediatric (<16 years) trauma death records in Ontario from 2001-2003.
• Comparison with data from 1985-1987 using identical criteria for preventability.
• Exclusion of cases where care was not sought and deaths due to asphyxia.

Main Results:

• A preventable death rate of 7% was identified in the 2001-2003 cohort.
• This represents a significant decline from the previous 21% rate (p < 0.001).
• A relative risk reduction of 68% for preventable death was observed.

Conclusions:

• The threefold decline in preventable pediatric trauma deaths suggests the effectiveness of trauma system improvements.
• System changes are estimated to have eliminated one preventable death for every seven fatal injuries.